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Inicio Annals of Hepatology O-18 ETHNIC DISPARITIES IN HISPANIC POPULATION WITH ALCOHOL ASSOCIATED LIVER DIS...
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Vol. 28. Núm. S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(marzo 2023)
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Vol. 28. Núm. S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(marzo 2023)
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O-18 ETHNIC DISPARITIES IN HISPANIC POPULATION WITH ALCOHOL ASSOCIATED LIVER DISEASE AND TRANSPLANT ENLISTED PATIENTS: A RETROSPECTIVE STUDY OF TWO LARGE DATABASES IN THE UNITED STATES FROM 2011-2018
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Gustavo Ayares1, Luis Antonio Díaz1, Eduardo Fuentes-López2, Francisco Idalsoaga1, Jorge Arnold1, Thomas Cotter3, Winston Dunn4, Douglas Simonetto5, Vijay Shah5, Patrick Kamath5, Ramon Bataller6, Marco Arrese1, Robert J. Wong7, Ashwani K. Singal8, Juan Pablo Arab1
1 Department of Gastroenterology, Medical School, Pontifical Catholic University of Chile, Santiago, Chile
2 Health Sciences Department, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
3 Division of Gastroenterology and Hepatology, UT Southwestern Medical Center, Texas, USA
4 University of Kansas Medical Center, KS, USA
5 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
6 Center for Liver Diseases, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, PA, USA
7 Division of Gastroenterology and Hepatology, VA Palo Alto Healthcare System, Stanford University School of Medicine, Stanford, CA, USA
8 Department of Medicine, University of South Dakota Sanford School of Medicine, Division of Transplant Hepatology, Avera Transplant Institute, Sioux Falls, SD, United States
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Vol. 28. Núm S1

Abstracts of the 2022 Annual Meeting of the ALEH

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Introduction and Objectives

there are different variables in patients with alcohol associated liver disease (ALD) and enlisted patients for liver transplant (LT), such as ethnicity, that determine health disparities in access, morbidity and mortality. This study aimed to assess and measure the impact of ethnicity in ALD and patients enlisted for LT.

Materials and Methods

we conducted a retrospective study using U.S databases, the National Health and Nutrition Examination Survey (NHANES) and the United Network for Organ Sharing (UNOS) from 2011 to 2018. We created a multivariate model analyzing the clinical characteristics of the interviewed patients for NHANES. Alcohol consumption and ethnicity were self-reported. We also created a competing risks model for time to LT in enlisted patients.

Results

of the 39,156 interviewed patients, 17.1% identified as Hispanic. In this group, the prevalence of ALD was 9.0% and the average consumption of pure alcohol was 2.3 L/year. The multivariate-adjusted model showed that Hispanics were independently associated with a higher risk of ALD (OR 1.30; 95%CI: 1.05-1.60, p=0.018). Of the enlisted patients, 13.6% were Hispanic. White ethnicity, lower age, male sex, higher MELD score, renal failure, lower BMI, higher education and private insurance were associated with a higher rate of LT. Hispanics were independently associated with a lower LT (HR 0.80; 95%CI: 0.74-0.87, p<0.001).

Conclusions

ethnicity is an important factor in healthcare outcomes. This is a growing area of interest, and research should be carried out to better our understanding of the impact that these disparities have on patients. Studying ethnic minority groups is needed to enable researchers to face the challenges of reducing and ultimately eliminating health disparities.

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Tabla 1. Competitive Risk Model for Patients Enlisted for Liver Transplant

VariableUnivariate Model  P Value  Adjusted Multivariate Model  P Value 
hazard ratio (IC 95%)
Whites (ref)  ref  ref  ref  ref 
vs Blacks  1.18 (1.07-1.31)  0.002  1.03 (0.87-1.23)  0.726 
vs Hispanics  0.90 (0.85-0.95)  <0.001  0.80 (0.74-0.87)  <0.001 
vs Asian  0.85 (0.72-1.00)  0.046  0.98 (0.82-1.19)  0.867 
vs Other  0.83 (0.71-0.98)  0.026  0.82 (0.64-1.04)  0.100 
Men  1.13 (1.08-1.18)  <0.001  1.01 (0.94-1.07)  0.875 
Age at Enlistment  0.98 (0.98-0.99)  <0.001  0.99 (0.98-0.99)  <0.001 
MELD (Model for End-Stage Liver disease)  1.26 (1.24-1.26)  <0.001  1.04 (1.03-1.05)  <0.001 
Diabetes Mellitus  0.97 (0.92-1.02)  0.187 
Hepatocellular carcinoma  1.02 (0.92-1.14)  0.66 
Obesity  0.99 (0.98-0.99)  0.010  0.99 (0.98-0.99)  0.16 
Renal Failure  1.60 (1.54-1.67)  <0.001  1.40 (1.32-1.47)  <0.001 
Education <”High school”  ref  ref  ref  ref 
Education “Some College”  1.03 (0.98-1.08)  0.195  0.99 (0.93-1.06)  0.860 
Education “College-Bachelor”  1.07 (1.02-1.12)  0.006  1.04 (0.97-1.11)  0.263 
Medicare  ref  ref  ref  ref 
Medicaid  1.01 (0.93-1.11)  0.721  0.98 (0.89-1.09)  0.760 
Private Insurance  1.18 (1.10-1.27)  <0.001  1.01 (0.93-1.10)  0.784 

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