Impact of Race on Admission, Clinical Outcomes, and Disposition in Cholangiocarcinoma: Insights from the National Inpatient Database

Background: Cholangiocarcinoma, malignancies arising from intrahepatic and extrahepatic bile ducts, have increased in incidence in the United States over the past few decades. The reported incidence of cholangiocarcinomas is high, particularly in certain racial groups such as Asian and Pacific Islanders. Race also significantly impacts disparities in healthcare utilization and clinical outcomes. Our study focused on the impact of race on admission, clinical outcomes, and disposition of cholangiocarcinoma. Methods: We performed a retrospective analysis of cholangiocarcinoma-related hospital admissions, using the National Inpatient Sample for the year 2022. Patients were stratified according to race into the following groups: White, African Americans, Hispanics, Asian or Pacific Islanders, Native Americans, and Others. The data analysis was performed using STATA/BE version 18.5. Univariate and Multivariable logistic regression models were applied to evaluate the relationship between race and clinical and healthcare utilization outcomes. Results: In 2022, 7479 hospitalizations were recorded for cholangiocarcinoma in the United States. Among these, 65.99% were Whites, 13.27% Hispanics, and 10.13% African-Americans. There was a statistically significant difference in gender distribution across racial groups (p< 0.001), with males comprising the majority in all groups. Males outnumbered females in all racial groups except among Hispanics. Significant racial disparities in mortality were observed, with White patients showing a mortality rate of 6.69%, compared to higher rates among African-American (9.76%), Native American (8.51%), and Asian or Pacific Islander (8.09%) patients, while Hispanic (5.04%) and Other (5.88%) groups had lower rates (p< 0.001). Conclusions: The study underscores the racial disparities among cholangiocarcinoma hospitalizations, with African Americans, Native Americans, and Asian patients facing disproportionately higher mortality and poorer in-hospital outcomes compared to White patients. This analysis highlights the healthcare strategies and policy reforms to promote equitable treatment by mitigating these disparities and to improve cholangiocarcinoma outcomes.

Hali tarjima qilinmagan