S2493 Racial and Demographic Disparities in Mortality Among Patients With Acute Liver Failure: A National Inpatient Sample Analysis

Introduction: Acute liver failure (ALF) is a rapidly progressive and life-threatening condition that often results in multiorgan failure and high in-hospital mortality. Understanding demographic disparities in ALF outcomes is critical for investigating equitable healthcare strategies. This study investigates mortality patterns in ALF patients based on sex and race. Methods: We conducted a retrospective analysis of the National Inpatient Sample (NIS) database from 2019 to 2021. Patients hospitalized with a primary diagnosis of acute liver failure were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Patient demographic data was stratified based on sex and race. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality across each subgroup. STATA software was utilized for statistical analysis. Results: Among the 591,435 patients with acute liver failure as their primary diagnosis, 223,976 (37.9%) died during hospitalization. The sex distribution demonstrated a higher proportion of men diagnosed with acute liver failure (56.0%) compared to women (44.0%). Racial distribution of acute liver failure patients was as follows: White (64.8%), Black (14.8%), Hispanic (12.7%), Asian or Pacific Islander (3.1%), Native American (1.1%), and Other (3.4%) Significant disparities in mortality were observed across racial groups (P < 0.0001). Black patients had the highest mortality rate at 43.1%, followed by patients identified as other (41.2%), Asian or Pacific Islander (40.5%), White (35.2%), Hispanic (33.7%) and Native American (29.9%). Conclusion: This national analysis highlights substantial racial disparities in in-hospital mortality among patients with acute liver failure. Black and Asian or Pacific Islander patients experienced disproportionately higher mortality as compared to White and Hispanic patients. These differences may suggest underlying disparities in access to prompt healthcare, socioeconomic barriers, or systemic biases in healthcare delivery. Further research is needed to identify contributing factors and develop interventions to reduce such inequities and improve ALF outcomes across all demographic groups.