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Racial and Ethnic Disparities in Outcomes After the Development of Ascites: A National Cohort Study.
Solano, Quintin P; Chen, Xi; Parikh, Neehar D; Tapper, Elliot B.
Afiliación
  • Solano QP; Division of Internal Medicine, University of Michigan, Ann Arbor, USA.
  • Chen X; Division of Gastroenterology and Hepatology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
  • Parikh ND; Division of Gastroenterology and Hepatology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
  • Tapper EB; Division of Gastroenterology and Hepatology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA. etapper@med.umich.edu.
Dig Dis Sci ; 69(9): 3214-3219, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39080087
ABSTRACT

INTRODUCTION:

Ascites, a severe complication of cirrhosis, significantly impacts patient morbidity and mortality especially in Black patients. Access to disease optimizing care has been proposed as a potential driver of this disparity. In this study, we evaluate TIPS utilization across racial and ethnic groups.

METHODS:

We examined data from a 20% random sample of US Medicare enrollees with continuous Part D coverage. We required 180 days of continuous outpatient enrollment prior to cirrhosis diagnosis and all patients had ≥1 paracentesis within 180 days of their cirrhosis diagnosis. Time zero was the date of the first paracentesis. We assessed the likelihood of TIPS placement. Analyses were conducted to determine the independent associations between each outcome and race/ethnicity.

RESULTS:

5915 patients (average age 68.2, 64.4% male) were included in the analysis. 439 (7.4%) patients were identified as Black, 223 (3.8%) as Hispanic, and 4942 (83.6%) as white. When compared to white patients in a multivariable analysis, Black patients were less likely to receive a TIPS procedure (hazard ratio 0.4; 95% confidence interval (CI) 0.2-0.8) and had less days alive outside of the hospital (-100.5; 95% CI -189.4 - -11.6). There were no significant differences in transplant-free survival or number of paracenteses per year between ethnic and racial groups.

CONCLUSION:

Black patients are less likely to receive a TIPS procedure when controlling for common patient- and disease-specific variables. Access to optimal specialized services may be a significant driver for disparities in outcomes of patients with cirrhosis between racial and ethnic groups.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ascitis / Hispánicos o Latinos / Población Blanca / Disparidades en Atención de Salud / Cirrosis Hepática Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Dig Dis Sci Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ascitis / Hispánicos o Latinos / Población Blanca / Disparidades en Atención de Salud / Cirrosis Hepática Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Dig Dis Sci Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos