S2382 Socioeconomic Factors Among Chronic Liver Disease Patients: Experience From Largest Tertiary Care Hospital of Pakistan

Introduction: Pakistan has 1 of the highest global rates of viral hepatitis, contributing significantly to the prevalence of chronic liver disease (CLD). The progression and outcomes of CLD are influenced by social determinants of health (SDOH), including economic disparities, healthcare accessibility, environmental conditions, and public awareness. Understanding these factors will enhance disease prevention and management. The objective of the study was to analyze the economic and social challenges confronting CLD patients in Karachi, Pakistan. Methods: It is an ongoing cross-sectional study from August 2024 till to date. This study included CLD patients and their socioeconomic status, healthcare access, education, social and community context, neighborhood built environment, hospitalizations or readmissions, as well as disease complications, these were among the outcome variables of interest. Results: The study enrolled 1,200 patients with CLD, predominantly from Sindh 1179 (94%) and Balochistan 41 (3.2%). Out of this 665 (53%) were men and 586 (47%) were women, with a mean age of 50 ± 13 years. Within Sindh, Karachi was home to the majority 1043 (83%), particularly the outskirts 213 (17%), followed by Malir 184 (15%), Korangi 174 (14%), Orangi 167 (13%), and Central Karachi 161 (13%). A significant proportion 893 (71.4%) had decompensated (DCLD), with a Child-Turcotte-Pugh (CTP-B) score in 767 patients (62%) and a MELD score below 15 in 922 (74%). Stratification by income revealed significant disparities in disease severity and clinical complications. Patients in the low-income group exhibited disproportionately higher rates of DCLD: 81% vs 50% (middle-income) and 25% (high-income), CTP class B: 72% vs 35% and 24% and MELD score <15: 61% vs 100% and 96%. Complications were also more frequent among low-income patients, Jaundice: 68% (vs 48% and 28%), Ascites: 57% (vs 35% and 16%), Upper GI bleed: 56% (vs 33% and 21%) Hepatic encephalopathy: 38% (vs 15% and 8%). All associations were statistically significant (P < 0.001). These findings indicate a clear socioeconomic gradient in CLD severity, with the lowest-income patients experiencing the greatest disease burden and complications. Conclusion: Low-income patients with CLD experience significantly higher rates of disease severity and complications, underscoring the critical impact of socioeconomic status on clinical outcomes and healthcare disparities. These important elements must not be disregarded to prevent disease-related morbidity.