P0718 - Clinical Features of Men and Women With Primary Biliary Cholangitis: A National Cohort Study

Sunday, October 24, 2021

3:30 PM – 7:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Mengdan Xie, MD

Mount Sinai West and Morningside Hospitals
New York, NY, United States

Mengdan Xie, MD¹, Ilan Weisberg, MD, MSc²
¹Mount Sinai West and Morningside Hospitals, New York, NY; ²Mount Sinai Morningside and Mount Sinai West/Mount Sinai Beth Israel Medical Center, New York, NY

Introduction: Backgrounds: Primary biliary cholangitis(PBC) is a rare chronic inflammatory disease characterized by autoimmune destruction of bile ducts. Female patients account for 90-95% of PBC cases. The reasons underlying the low incidence of PBC in men remain unknown. This study aims to compare the clinical features among hospitalized men and women PBC patients in a national cohort.

Methods: A retrospective cohort study based on the 2016 Nationwide Inpatient Sample (NIS) database was performed. ICD-10 codes were utilized to identify the diagnosis. All patients >= 18 years old with history of PBC were included. Patients were divided into man and women groups. Age, race/ethnicity, rates of concurrent gastrointestinal bleeding(GIB) and other comorbidities, in-hospital all-cause mortality, length of stay (LOS), the total cost of the hospital admission, and rate of EGD and colonoscopy were compared between two groups. Multivariate regression was used to adjust for possible confounders.

Results: A total of 11,650 patients with history of PBC were identified, among which 1665(14%) were men and 9985 (86%) were women. Compared to female patients, male with PBC had similar mean age (male vs. female=63 vs. 65, p=0.15), race/ethnicity distribution(p=0.46), and Charlson Comorbidity Index (3.8 vs 3.6, p=0.18). As for comorbidities, men with PBC had significant lower rates of concurrent hypertension(50% vs. 56%, p=0.04), chronic pulmonary disorders(15% vs. 24%, p=0.001), diabetes(13% vs. 30%, p< 0.001), and rheumatic diseases/collagen vascular diseases(5% vs. 16%, p< 0.001); and significant higher rate of coagulopathy(32% vs. 25%, p=0.02), when compared to women. Rates of GIB were similar among men and women(20% vs. 20%, p=0.79), regardless of the source of bleeding. No significant difference in all-cause mortality, LOS, total cost of the hospital admission, or rate of EGD/colonoscopy was identified among two groups.

Discussion: Conclusion: There was no significant difference in basic clinical features among hospitalized men and women PBC patients. Interestingly, despite the overall higher prevalence of hypertension and diabetes in men than in women, it showed the opposite pattern in PBC. The role of genetic and hormonal differences in the pathogenesis of PBC and related comorbidities requires further study. Furthermore, men with PBC presented with higher rates of life-threatening complications such as GIB in published studies, but similar difference was not shown in our large national cohort.

		Male	Female	p value
N		1665(14%)	9985(86%)
Age(mean, yo)		63	65	0.15
Race				0.46
	White	74%	74%
	Black	9%	6%
	Hispanic	11%	13%
	Asian or pacific islander	4%	3%
	Native American	1%	1%
	Other	2%	3%
Charlson Comorbidity Index		3.8	3.6	0.18
Comorbidities	Congestive heart failure	19%	18%	0.64
	Hypertension	50%	56%	0.04*
	chronic pulmonary disorder	15%	24%	0.00*
	Stroke	2%	1%	0.13
	Diabetes	13%	30%	0.00*
	Renal failure	26%	25%	0.62
	Rheumatic diseases/ collagen vascular diseases	5%	16%	0.00*
	Coagulopathy	32%	25%	0.02*
	Deficiency anemia	10%	9%	0.49
	Drug abuse	5%	2%	0.00*
	Psychosis	2%	0%	0.00*
	Depression	13%	20%	0.00*
Concurrent GIB	All GIB	20%	20%	0.79
	Upper GIB (varices vs. non-varices)	10% (8% vs. 2%)	10% (7% vs. 4%)	0.96 (p >0.1)
	Lower GIB	1%	2%	0.14
	Other GIB	9%	8%	0.42
Procedures	EGD Rate (%)	11%	10%	0.49
	Colonoscopy Rate (%)	2%	5%	0.08
Other Outcomes	All Cause Mortality (%)	3%	5%	0.11
	LOS (day)	5.8	5.6	0.71
	Cost ($)	16186	16325	0.82

Table: Clinical Features of Men and Women with Primary Biliary Cholangitis

Disclosures:

Mengdan Xie indicated no relevant financial relationships.

Ilan Weisberg indicated no relevant financial relationships.

Mengdan Xie, MD¹, Ilan Weisberg, MD, MSc². P0718 - Clinical Features of Men and Women With Primary Biliary Cholangitis: A National Cohort Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.