Racial disparities in the initial treatment of hepatocellular carcinoma in the population 65+ years in the United States.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 431-431
Author(s):  
Stephanie Costa ◽  
David J. Delgado ◽  
Michael Ross Kaufman ◽  
Brandon George ◽  
Edith P. Mitchell
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
African American ◽  
Racial Disparities ◽  
Initial Treatment ◽  
The United States ◽  
Asian Pacific Islander ◽  
Receive Treatment ◽  
Asian Pacific ◽  
To Receive

431 Background: Insufficient evidence exists regarding the initial management of elderly patients with hepatocellular carcinoma (HCC). The purpose of this study was to describe racial differences in initial treatment of 65+ year old patients with HCC diagnosed in the United States (2004-2014). Methods: A retrospective cohort study was conducted using the 1973-2014 Surveillance, Epidemiology and End Results Program (SEER) database of the National Cancer Institute. Patients with primary hepatocellular carcinoma, diagnosed between 2004 and 2014, and with complete information on race, gender, year of diagnosis, age, marital status, region, tumor status at diagnosis and initial treatment were included. Descriptive statistics were used to compare race with sociodemographic and clinical variables. Univariate and multivariate logistic regressions were performed to describe the association of race with receiving any treatment for HCC (local hepatic therapy and surgical treatment versus no treatment). Results: The sample consisted of 25,499 HCC patients: 70.0% White, 9.1% Black, 19.8% API, 1.0% AI; 68.6% male; 46.8% diagnosed in 2004-2009; 54.8% age 65-74, 45.2% 75 and older; 54.7% married, 7.3% Midwest, 13.8% Northeast, 15.7% Southeast; 81.3% first malignant primary indicator, 13.8% metastasis, 49.3% localized site, and 20.9% receiving initial treatment. After controlling for confounding variables, as compared to White patients, African American patients (OR:0.739 95% CI:0.652, 0.839) had decreased odds of receiving initial treatment; and Asian/Pacific Islander patients (OR:1.490 95% CI:1.371,1.618) had increased odds of receiving initial treatment. Conclusions: Racial disparities exist at the presentation of HCC in the 65+ population. African American patients are less likely to receive treatment and Asian/Pacific Islander patients are more likely to receive treatment. Further research is needed to understand these relationships in subpopulations.

Racial disparities in the presentation of hepatocellular carcinoma in the population 65+ years in the United States.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 249-249
Author(s):  
Michael Ross Kaufman ◽  
David J. Delgado ◽  
Stephanie Costa ◽  
Brandon George ◽  
Edith P. Mitchell
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Racial Disparities ◽  
Late Stage ◽  
The United States ◽  
Pacific Islanders ◽  
Stage Iii ◽  
Ajcc Stage ◽  
Asian Pacific Islanders ◽  
Asian Pacific

249 Background: Insufficient evidence exists regarding the presentation and management of elderly patients with hepatocellular carcinoma (HCC). The purpose of this study was to describe racial differences in cancer staging of elderly (65+) patients with HCC diagnosed in the United States. Methods: A retrospective cohort study was conducted using the 1973-2014 Surveillance, Epidemiology and End Results Program (SEER) database of the National Cancer Institute. Patients with primary hepatocellular carcinoma, diagnosed between 2004 and 2014, and with complete information on race, gender, year of diagnosis, age, marital status, region and stage at diagnosis (Derived SEER Summary Stage 2000, and Derived American Joint Committee on Cancer (AJCC) Stage Group, 6th Edition) were included. Descriptive statistics were used to compare sociodemographic and clinical variables with race. Univariate and multivariate logistic regressions were preformed to describe the association of race with the diagnosis of late stage HCC (Regional/Distant vs Localized Stage for SEER Summary Stage, and Stage III/IV vs Stage I/II for AJCC Stage Group). Results: The sample consisted of 19,902 HCC patients: 69.7% White, 9.2% Black, 20.2% API, 1.0% AI; 69.1% male; 45.1% diagnosed in 2004-2009; 56.2% age 65-74, 35.6% 75-84, and 8.2% 85 and older; 58.3% married; 7.4% Midwest, 12.4% Northeast, 17.0% Southeast, 63.2% Pacific West; 44.9% Regional/Distant Stage (SEER Summary Stage) and 41.2% Stage III/IV (AJCC Stage Group). After controlling for confounding variables, Asian/Pacific Islanders had a decreased odds of presenting with late stage disease relative to whites in both the SEER Summary Stage (OR: 0.867, CI:0.805-0.934) and AJCC Stage Group (OR: 0.904, CI:0.838-0.975). Conclusions: Racial disparities exist at the presentation of HCC in the 65+ population. Asian/Pacific Islanders are less likely to be diagnosed with late stage HCC compared to whites. There is a need to study further these relationships in subpopulations.

Racial Disparities in Inhospital Outcomes for Hepatocellular Carcinoma in the United States

2016 ◽  
Vol 91 (9) ◽  
pp. 1173-1182 ◽  
Author(s):  
Ruma Rajbhandari ◽  
Rachel E. Simon ◽  
Raymond T. Chung ◽  
Ashwin N. Ananthakrishnan
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Racial Disparities ◽  
The United States

scholarly journals Disparities in Opioid Use Disorder Treatment Admissions in the United States

2020 ◽  
Vol 7 (1) ◽  
pp. 85-93
Author(s):  
Peter Mallow ◽  
Michael Mercado ◽  
Michael Topmiller
Keyword(s):  
United States ◽  
Wait Time ◽  
The United States ◽  
Opioid Use Disorder ◽  
P Value ◽  
Opioid Use ◽  
Data Set ◽  
Significant Difference ◽  
Receive Treatment ◽  
To Receive

Objectives: The Cincinnati region has been at the epicenter of the nation’s unfolding opioid epidemic. The objectives of this study were twofold: (1) to compare the Cincinnati region to the United States in length of time to obtain treatment and planned medication-assisted therapy for the treatment for opioid use disorder (OUD); and (2) to assess racial disparities within the Cincinnati region in wait time and type of treatment. Methods: The 2017 Treatment Episode Data Set: Admissions (TEDS-A) from the Substance Abuse and Mental Health Services Administration (SAMHSA) was used to identify a cohort of eligible individuals with a primary substance use of opioids, including opioid derivatives. Logistic regression models were performed to assess the differences for treatment wait time and type of planned treatment. Model covariates included patient demographics and socioeconomic characteristics. Three different models were performed to assess the influence of covariates of the outcomes. Results: There were 678 766 US and 3298 Cincinnati region individuals admitted for OUD treatment in 2017. The rate per 1000 for treatment admissions was 2.08 and 1.51 (P value < 0.0001) for the United States and Cincinnati, respectively. The fully saturated regression results found that the odds of Cincinnati individuals receiving planned medication-assisted therapy were 0.497 (95% CI, 0.451–0.546; P value < 0.001). The odds of waiting longer for treatment in Cincinnati were higher than in the United States as a whole: 2.33 (95% CI, 2.19–2.48; P value < 0.001). In Cincinnati, there were 3102 Caucasian, 123 African American, and 73 Other admissions. The fully saturated model results found that Caucasians and Other had an increased likelihood of receiving planned medication-assisted therapy (OR 1.89, P value 0.039; OR 7.07, P value 0.002, respectively) compared to African Americans. Within Cincinnati, there was not a statistically significant difference in the likelihood of waiting time to receive treatment by race. Conclusion: Individuals seeking treatment for OUD in Cincinnati were less likely to receive planned medication-assisted therapy and were more likely to wait longer than individuals in the United States as a whole. These results suggest that the demand for treatment is greater than the supply in Cincinnati. Within Cincinnati, there does not appear to be a racial disparity in treatment type or length of time to receive treatment for OUD.

scholarly journals Hospitalizations for Acute Salicylate Intoxication in the United States

2020 ◽  
Vol 9 (8) ◽  
pp. 2638
Author(s):  
Charat Thongprayoon ◽  
Tananchai Petnak ◽  
Wisit Kaewput ◽  
Michael A. Mao ◽  
Karthik Kovvuru ◽  
...  
Keyword(s):  
United States ◽  
Hospital Mortality ◽  
Resource Use ◽  
Kidney Failure ◽  
The United States ◽  
Primary Diagnosis ◽  
Asian Pacific Islander ◽  
Suicidal Attempts ◽  
Salicylate Intoxication ◽  
Asian Pacific

Background: The objective of this study was to describe inpatient prevalence, characteristics, outcomes, and resource use for acute salicylate intoxication hospitalizations in the United States. Methods: A total of 13,805 admissions with a primary diagnosis of salicylate intoxication from 2003 to 2014 in the National Inpatient Sample database were analyzed. Prognostic factors for in-hospital mortality were determined using multivariable logistic regression. Results: The overall inpatient prevalence of salicylate intoxication among hospitalized patients was 147.8 cases per 1,000,000 admissions in the United States. The average age was 34 ± 19 years. Of these, 35.0% were male and 65.4% used salicylate for suicidal attempts. Overall, 6% required renal replacement therapy. The most common complications of salicylate intoxication were electrolyte and acid-base disorders, including hypokalemia (25.4%), acidosis (19.1%), and alkalosis (11.1%). Kidney failure (9.3%) was the most common observed organ dysfunction. In-hospital mortality was 1.0%. Increased in-hospital mortality was associated with age ≥30, Asian/Pacific Islander race, diabetes mellitus, hyponatremia, ventricular arrhythmia, kidney failure, respiratory failure, and neurological failure, while decreased in-hospital mortality was associated with African American and Hispanic race. Conclusion: hospitalization for salicylate intoxication occurred in 148 per 1,000,000 admissions in the United States. Several factors were associated with in-hospital mortality.

Sign in / Sign up

Export Citation Format

Share Document