MedStar Georgetown University Hospital Washington, DC, United States
Nuval Cherian, MD, Esha Parikh, DO, Arul Thomas, MD MedStar Georgetown University Hospital, Washington, DC
Introduction: Primary sclerosing cholangitis (PSC) is an often-progressive disease that leads to complications of cholangitis, cirrhosis and malignancy. The primary intervention to alter the disease course is liver transplantation. Prior studies that describe the natural history and prognosis of PSC have primarily been conducted in predominately white European cohorts. Less is known about the course of PSC in diverse North American populations, particularly black populations.
Methods: A retrospective chart review of patients with PSC was conducted using the electronic medical record of a Mid-Atlantic U.S. hospital system. 115 black patients and 233 white patients were identified from patient encounters from 2010 to 2019. Patients from other races or without documented race were excluded from the analysis. Fisher’s exact test was used to calculate associations between race and the outcomes of transplant, death, and a combined endpoint of transplant or death. Two-tailed t-test was used to compare times from diagnosis to different outcomes; patients with unknown diagnosis times were excluded from this portion of the analysis.
Results: 38 black patients (33.0%) underwent a liver transplantation compared with 48 white patients (20.6%) (p=0.017). Time from diagnosis to transplant was 6.5 years (n=34) for black patients and 9.7 years (n=27) for white patients (p=0.09). 17 black patients (14.8%) and 24 white patients (10.3%) died (p=0.22). Time from diagnosis to death was 6.6 years (n=15) for black patients and 14.1 years (n=22) for white patients (p=0.008). Finally, 51 black patients (44.3%) and 67 white patients (28.8%) had end point of either death or liver transplantation (p=0.005). Time from diagnosis to death or transplantation was 6.6 years (n=47) for black patients and 11.0 years (n=44) for white patients (p=0.005).
Discussion: In this cohort of patients, there was a significant association between black race and liver transplantation and the combined endpoint of liver transplantation or death. Time to these events from diagnosis was shorter in black compared to white patients. Despite the small size of this retrospective study, there is a more severe clinical course for black patients with PSC diagnosed in a Mid-Atlantic U.S. hospital system.
Nuval Cherian indicated no relevant financial relationships.
Esha Parikh indicated no relevant financial relationships.
Arul Thomas indicated no relevant financial relationships.
Nuval Cherian, MD, Esha Parikh, DO, Arul Thomas, MD. P0725 - Death and Liver Transplantation Rates in Black and White Patient Populations With Primary Sclerosing Cholangitis Seen in a Large US Health Care Network, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.