S2038 Impact of Race and Socioeconomic Disparities on Major Liver Adverse Events in Patients With Inflammatory Bowel Disease: A Study Using the National Inpatient Sample

Introduction: Inflammatory bowel disease (IBD) is associated with worse outcomes in patients with chronic liver disease (CLD). However, it remains unclear which specific complications constitute major adverse liver outcomes (MALO) and to what extent racial and socioeconomic disparities contribute to these outcomes. The aim of our study is to identify MALO in patients with both IBD and CLD, while evaluating the influence of race and socioeconomic status. Methods: This retrospective cohort study analyzed hospitalized adults with IBD and CLD using the National Inpatient Sample database (2015–2021). Demographic variables included age, sex, and race/ethnicity. Socioeconomic status included household income. Clinical variables included length of hospital stay, in-hospital mortality, and the presence of common comorbidities. Results: Among 97,628 hospitalized adult IBD patients, 4.11% had secondary CLD. Majority of IBD-CLD were White (74.94%) and from lower-income households (53.83% had income <$35,000). Racial disparities were evident, with significant differences in comorbidities such as sepsis, cholangitis, and hepatocellular carcinoma. Depression (20.18%) and anxiety (24.21%) were prevalent, especially among White patients. Multivariable regression analysis demonstrated that African Americans had higher odds of MALO compared to Whites (OR 1.42, P = 0.003). Additionally, lowest socioeconomic status (OR 1.19, P = 0.04), older age (≥50 years; OR 2.15, P < 0.001), and extended hospital stay (≥5 days; OR 1.26, P = 0.002) were independently associated with increased MALO. Female sex was associated with reduced odds of MALO (OR 0.68, P < 0.001). Conclusion: Older age, prolonged hospitalization, African American race, and lower socioeconomic status significantly increase odds of MALO in IBD patients with CLD. Interventions reducing health inequities are desperately needed to mitigate disparities amongst this patient population.