Clinical

Blacks at increased risk for death post-hepatectomy

Last Updated: 2008-09-18 11:44:27 -0400 (Reuters Health)

NEW YORK (Reuters Health) - African-American patients are approximately twice as likely as their Caucasian counterparts to die following major hepatectomy, US researchers report.

Exactly why this is the case is unclear, but it does not seem to relate to clinical factors, hospital factors, or insurance status, according to the report in the Journal of the American College of Surgeons for September.

"Our study shows a racial divide in regards to in-hospital mortality after major hepatectomy," senior author Dr. Timothy Pawlik, from Johns Hopkins University School of Medicine in Baltimore, said in a statement. "This finding is of special note because of the magnitude of the observed gap in outcomes."

Dr. Pawlik's team analyzed hospital discharge data for 3552 patients who were entered in the Nationwide Inpatient Sample and underwent major hepatectomy from 1998 to 2005. Of the subjects, 59% were Caucasian, 6% African-American, 5% Hispanic, 7% Asian/Pacific Islander, and 24% other or unknown.

After adjusting for potential confounders, in-hospital mortality was 2.15-times higher for African-Americans compared with Caucasians. Moreover, as mentioned, a racial gap was still apparent on subanalyses based on patient factors including comorbidities, insurance status, and hospital caseload.

"There has previously not been any research on racial disparities in the outcomes of liver resection, but it is an important issue to examine as the use of hepatic resection has increased dramatically in the US," lead author Dr. Hari Nathan, also from Johns Hopkins, said in a statement.

Dr. Nathan added that further research is needed to better understand the cause of the racial disparity identified and the best means to intervene.

J Am Coll Surg 2008;207:312-319.