Demographic trends and in-hospital mortality data in patients with hepatocellular carcinoma.

Abstract

e16648 Background: Hepatocellular carcinoma (HCC) remains the 4th leading cause of cancer related mortality in the US. The incidence of HCC in the US appears to be increasing in specific demographic subgroups (Caucasian males, Hispanics and in the Southern US). Older studies identified substantial racial and ethnic differences in treatment and survival in HCC. There is a lack of large scale studies exploring the mortality patterns in patients hospitalized with HCC. Methods: The National Inpatient Sample was used to extract admissions for HCC using the ICD-9 code 155.0 from the years 2010 to 2014. The sample was weighted to approximate the full inpatient population of the U.S. over the 5-year interval. Univariate analysis was performed to determine the frequency distribution and bivariate analysis was performed using Chi Square test to determine the in-hospital mortality percentage. Results: A total of 52,868 (weighted = 262845) admissions were extracted from the years 2010 to 2014. While the number of patients admitted with HCC steadily increased over the 5-year study period, the overall in-hospital mortality decreased significantly from 9.35% to 7.68% (p < 0.0001). The mortality was highest for patients with African American ethnicity at 11.2% and for uninsured patients at 13%. The mortality rate among patients in the low income group (0-25th percentile) was 10.2 %, significantly higher (p = 0.0005) than other income groups. Conclusions: Even though the incidence of in-hospital mortality in HCC patients is decreasing, there appears to be a disparity in mortality data among patients of low socioeconomic status, self-pay or uninsured status and among African Americans. Our study further confirms the persistence of racial,economic and social disparities and highlights the need for additional equity research to understand the reasons for these differences and to improve outcomes for these subgroups of patients.