E0485 - Demographics of Decompensated Cirrhotic Patients Who Present to an Urban Tertiary Care Hospital

Shalini Gingipally, MD¹, Aaron Yazdian, MD¹, Zachary Jurkowski, MD¹, Nicholas Talabiska, DO², Holly S. Greenwald, MD¹, Christopher Kasia, MD¹, Marlana Radcliffe, MD¹, Kimberly Forde, MD, PhD³, Lee Peng, MD, PhD^1
1Temple University Hospital, Philadelphia, PA; ²Geisinger Medical Center, Philadelphia, PA; ³Temple University, Philadelphia, PA

Introduction: Decompensated cirrhosis is a common condition encountered at our urban, tertiary care center. Patients were admitted to either our primary hepatologist led service (HH), hospitalist led service with a hepatology consult (MH), or hospitalist led service without a hepatology consult (GM). We aim to identify demographic and clinical profiles of patients who presented for decompensated cirrhosis and were admitted to each of these services.

Methods: A retrospective chart review was conducted on 1,058 patients who presented to our tertiary care center for decompensated cirrhosis between January 1, 2016 and December 31, 2020. Patients admitted to the hospital with a complication of cirrhosis such as hepatic encephalopathy, ascites, gastrointestinal bleeding, hepatorenal syndrome, hepatocellular carcinoma, or spontaneous bacterial peritonitis were included in the study cohort. Demographic data, including age, gender, race, ethnicity, and BMI were recorded. We compared patient demographics of each service: HH, MH, and GM. Stata statistical software was utilized for statistical analysis.

Results: 349 patients met study criteria of which 115 patients were on GM, 112 on MH, and 122 on HH services. Most of our patients were male (49.6% on GM, 58.9% on MH, and 62.3% on HH, p = 0.13). Patients on GM services tended to be younger (56.1 years) compared to their MH and HH counterparts (59.2 vs 59.1 years respectively, p = 0.02). Additionally average BMI between the services was similar [GM (27.0), MH (26.7), and HH (28.1); p = 0.37]. Patients on all services were mainly non-Hispanic (56.5% on GM, 60.7% on MH, and 62.3% on HH, p = 0.55). However, when compared against each other, there were differences demonstrated between race on each service. The HH service had a higher number of Caucasian/white patients compared to the GM and MH services (32.7% vs 23.5% and 21.4% respectively, p = 0.02), while the GM services had a higher number of African American/black patients compared to HH services (36.5% vs 22.1%, p = 0.02).

Discussion: This study found a difference amongst patients’ race on the HH service compared to GM service. The difference may reflect the better establishment of care of white patients at outpatient hepatology clinics, thereby leading to admissions on hepatologist led services which in turn can lead to greater listing of white patients for orthotopic liver transplantation.



Disclosures:


Shalini Gingipally, MD¹, Aaron Yazdian, MD¹, Zachary Jurkowski, MD¹, Nicholas Talabiska, DO², Holly S. Greenwald, MD¹, Christopher Kasia, MD¹, Marlana Radcliffe, MD¹, Kimberly Forde, MD, PhD³, Lee Peng, MD, PhD¹. E0485 - Demographics of Decompensated Cirrhotic Patients Who Present to an Urban Tertiary Care Hospital, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.