Journal article
The Association of Race With Outcomes in Hospitalised Patients With Hepatorenal Syndrome: Nationwide Cohort Study
Liver international, Vol.45(1), e16226
01/2025
DOI: 10.1111/liv.16226
PMCID: PMC11669052
PMID: 39720837
Appears in UI Libraries Support Open Access
Abstract
Introduction
Racial/ethnic disparities have been previously reported in renal and hepatic disease care; however, acute kidney injury (AKI) in the setting of cirrhosis (hepatorenal syndrome [HRS]-AKI) despite its complexity requiring a multidisciplinary approach, remains understudied.
Methods
To identify unique associations of clinical and sociodemographic factors with mortality and length of stay (LOS) among patients hospitalised with HRS-AKI, hierarchical regression analysis was conducted, along with a mediation analysis to estimate how race-related differences in in-hospital mortality were influenced by payer type, area household income, and clinical severity.
Results
Black patients demonstrated a significantly higher odds of in-hospital mortality, compared to their white counterparts, adjusting for (1) sex and age, (2) sex, age, payer type, and area household income and (3) sex, age, and clinical severity [OR 1.16–1.20, 95% confidence intervals (CI) > 1]. Higher mortality rates among Black patients were partially mediated by clinical severity and area household income [proportion mediated (PM): 0.1890.190.192 and 0.160.170.18, respectively]. Black patients with HRS-AKI had longer LOS than White patients. Hispanic patients tended to have lower odds of in-hospital mortality [OR: 0.770.860.97] despite their lower income and more severe illness.
Conclusion
Our nationwide US study demonstrated that, partly due to higher clinical severity and lower household income, Black patients with HRS-AKI experience higher inpatient mortality, compared to White patients. On the other hand, Hispanics with HRS-AKI have a survival advantage. More awareness is warranted to address racial disparities in HRS-AKI outcomes.
Details
- Title: Subtitle
- The Association of Race With Outcomes in Hospitalised Patients With Hepatorenal Syndrome: Nationwide Cohort Study
- Creators
- Shahana Prakash - University of IowaMark Vander Weg - University of IowaTomohiro Tanaka - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Liver international, Vol.45(1), e16226
- DOI
- 10.1111/liv.16226
- PMID
- 39720837
- PMCID
- PMC11669052
- NLM abbreviation
- Liver Int
- ISSN
- 1478-3231
- eISSN
- 1478-3231
- Publisher
- Wiley
- Grant note
- Agency for Healthcare Research and Quality
- Language
- English
- Date published
- 01/2025
- Academic Unit
- Health Management and Policy; Psychological and Brain Sciences; Gastroenterology and Hepatology; Injury Prevention Research Center; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984759993602771
Metrics
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