Racial differences in primary sclerosing cholangitis: A retrospective cohort study leveraging a new ICD-10 code

Introduction and Objectives: There are limited data examining racial disparities in PSC-related clinical features and events. We aimed to leverage a new PSC ICD-10 code to characterize racial differences in a nationwide contemporary cohort of patients with PSC. Patients and Methods: We used de-ident...

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Main Authors: Melinda Wang, Alyssa Harris, Charles E. McCulloch, Sharad I. Wadhwani, Jennifer C. Lai, Jessica B. Rubin
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Annals of Hepatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1665268125001255
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Summary:Introduction and Objectives: There are limited data examining racial disparities in PSC-related clinical features and events. We aimed to leverage a new PSC ICD-10 code to characterize racial differences in a nationwide contemporary cohort of patients with PSC. Patients and Methods: We used de-identified clinical/administrative data from the Vizient® Clinical Data Base to identify outpatient and inpatient adult patients with PSC using a PSC-specific ICD-10-CM code (K83.01). We compared demographic and clinical characteristics between patients who self-identified as Black versus White race. Primary and secondary outcomes included clinical and healthcare utilization outcomes. Results: We identified 9850 patients with PSC: 79% White, 13% Black, 2% Asian, and 6% other. Compared with White patients, Black PSC patients were more likely to be female, younger, and have a higher Elixhauser Comorbidity Index (p<0.001). Black patients were less likely to have concurrent inflammatory bowel disease (IBD) but more likely to have overlap syndromes (p<0.001) compared to White patients. The black race was significantly associated with intensive care unit stays (aOR 1.69, 95%CI 1.38-2.06) and longer length of stay (aIRR 1.15, 95%CI 1.04-1.28), but similar total number of hospitalizations (aIRR 1.05, 95%CI 0.98-1.13) compared to the White race. Conclusions: Black patients had sociodemographic and clinical features suggestive of more severe disease compared to White patients. Although hospitalization rates were similar, Black patients received higher-intensity care. There was no significant difference in liver transplantation between Black and White patients. Additional research on optimal diagnosis and management of PSC in Black populations specifically is necessary to reduce healthcare disparities in this disease.
ISSN:1665-2681