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Racial disparities in treatment of patients with cirrhosis and complications of portal hypertension

African-American and Hispanic patients hospitalized for complications of portal hypertension were less likely to undergo a palliative shunt, prompt endoscopy, or liver transplantation compared to white patients, according to a new study in the May issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The article is also available online via Wiley Interscience (http://www.interscience.wiley.com/journal/hepatology).

Liver disease is very common in the United States and as it progresses, patients develop portal hypertension-related complications, such as variceal bleeding, ascites or hepatic encephalopathy. These patients should be considered for liver transplantation, without which they face a 2-year survival prognosis of less than 50 percent. While awaiting transplants, they may be candidates for palliative procedures including endoscopic band ligation or portosystemic shunts.

Previous studies have revealed widespread racial disparities in disease treatments and outcomes. To determine the influence of race and health insurance for patients with serious liver disease, including their likelihood of receiving palliative procedures or transplants, researchers, led by Paul J. Thuluvath. MD (and Geoffrey Nguyen, Fellow in Gastroenterology & Hepatology) of Johns Hopkins University School of Medicine examined a nationally representative, population-based sample of hospitalized patients with cirrhosis and complications of portal hypertension.

Using the Nationwide Inpatient Sample, the researchers included 63,696 patients with cirrhosis who were admitted to a hospital between 1998 and 2003 for a complication of portal hypertension. The researchers gathered demographic data, information on health insurance and treatment efforts, and then performed statistical analyses, adjusting for potential c
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
1-May-2007


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