Komlan Guedze, MD1, Kojo-Frimpong B. Awuah, MD2, Marissa Gorvet, DO3, Rashid Abdel-Razeq, MD4, Onwuzo Somotochukwu, MD2, Chidera Onwuzo, MD5, Tyrell Daniel, MD6 1Franciscan Health, Olympia Fields, IL; 2Allegheny Health Network, Pittsburgh, PA; 3Allegheny Health Network Medicine Institute, Pittsburgh, PA; 4Cleveland Clinic Foundation, Cleveland, OH; 5State University of New York Upstate Medical University, Syracuse, NY; 6Sentara Northern Virginia Medical Center, Woodbridge, VA Introduction: Cirrhosis, a progressive and often terminal liver disease, is a leading cause of morbidity and mortality worldwide. Previous research has documented disparities in liver-related health outcomes, yet comprehensive, multi-ethnic analyses spanning multiple decades remain limited. This study investigates racial and ethnic disparities in the incidence of key cirrhosis-related complications to inform equitable clinical care and health policy better. Methods: A retrospective analysis was performed using de-identified, aggregated data from the TriNetX research network, including patients diagnosed with cirrhosis from 2000 to 2024. Patients were stratified by race and ethnicity into six groups: American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, White, and Other Race. The primary outcomes assessed were the incidences of spontaneous bacterial peritonitis (SBP), esophageal varices, ascites, hepatic encephalopathy, and hepatocellular carcinoma (HCC). A 1:1 propensity score matching approach accounted for confounders, including age, sex, comorbidities (e.g., diabetes, hypertension, chronic kidney disease, and alcohol-related liver disease), and socioeconomic variables. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models, with White patients as the reference group. Results: Racial and ethnic differences were observed across all measured complications. American Indians or Alaska Natives exhibited the highest incidences of SBP (8.62%) and esophageal varices (35.32%). Ascites was most prevalent among Native Hawaiians or Other Pacific Islanders (42.41%), while hepatic encephalopathy was most frequent among American Indians or Alaska Natives (16.96%). In contrast, Asians had the lowest rates of SBP (3.38%) and esophageal varices (18.03%) but demonstrated the highest incidence of HCC (27.10%), emphasizing a unique oncologic burden. Discussion: This large-scale analysis highlights significant racial and ethnic disparities in the manifestation of cirrhosis-related complications. The findings underscore the necessity for culturally sensitive and demographically targeted interventions, including enhanced screening strategies and access to specialized care. Addressing these disparities is essential to achieving equitable health outcomes across diverse populations.
Figure: Figure 1. Incidence of cirrhosis-related complications stratified by race and ethnicity. This bar graph illustrates disparities in the proportion of patients affected by spontaneous bacterial peritonitis, esophageal varices, ascites, and hepatic encephalopathy. Notably, American Indian or Alaska Native patients had the highest incidence of esophageal varices and hepatic encephalopathy, while Asians demonstrated the highest incidence of hepatocellular carcinoma (not shown). These findings emphasize the need for targeted interventions to address racial and ethnic disparities in cirrhosis outcomes.
Disclosures: Komlan Guedze indicated no relevant financial relationships. Kojo-Frimpong B. Awuah indicated no relevant financial relationships. Marissa Gorvet indicated no relevant financial relationships. Rashid Abdel-Razeq indicated no relevant financial relationships. Onwuzo Somotochukwu indicated no relevant financial relationships. Chidera Onwuzo indicated no relevant financial relationships. Tyrell Daniel indicated no relevant financial relationships.
Komlan Guedze, MD1, Kojo-Frimpong B. Awuah, MD2, Marissa Gorvet, DO3, Rashid Abdel-Razeq, MD4, Onwuzo Somotochukwu, MD2, Chidera Onwuzo, MD5, Tyrell Daniel, MD6. P1539 - Racial and Ethnic Disparities in Cirrhosis-Related Complications: A Retrospective Cohort Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
