Major adverse cardiovascular complications event outcomes in liver cancer.

Abstract

e16336 Background: Liver cancer is a significant global health burden with racial and ethnic disparities affecting disease outcomes, healthcare resource utilization, and associated cardiovascular complications. Major adverse cardiovascular and cerebrovascular events (MACCE) contribute to morbidity and mortality in liver cancer patients, necessitating further investigation into racial differences. This study utilizes the National Inpatient Sample (NIS) from 2016–2021 to assess racial disparities in MACCE, mortality, and healthcare utilization among hospitalized liver cancer patients. Methods: A retrospective cohort study was conducted using the NIS database to identify adult liver cancer patients. Demographic and clinical characteristics, including race, socioeconomic status, and comorbidities, were compared. Key outcomes included in-hospital mortality, myocardial infarction (MI), stroke, intracranial hemorrhage, sudden cardiac arrest, arrhythmia, and healthcare utilization metrics (length of stay [LOS]). Multivariable logistic regression models adjusted for confounders to evaluate racial disparities in these outcomes. Results: Among 340,172 liver cancer patients, the racial distribution included White (56.5%), Black (15.0%), Hispanic (17.7%), Asian or Pacific Islander (6.6%), Native American (0.9%), and Other (3.8%). Black (OR 1.24, p < 0.001), Asian or Pacific Islander (OR 1.18, p = 0.002), and Other racial groups (OR 1.23, p = 0.004) had significantly higher odds of mortality compared to White patients. Hispanic and Asian patients had a lower risk of MI (OR 0.773, p = 0.002; OR 0.775, p = 0.03, respectively). However, Black (OR 1.85, p < 0.001), Hispanic (OR 1.398, p < 0.001), and Asian or Pacific Islander (OR 1.757, p < 0.001) patients were more likely to experience sudden cardiac arrest. Black and Hispanic patients had significantly lower odds of cerebral artery stenosis (OR 0.486, p < 0.001; OR 0.452, p < 0.001), while Black patients had an increased risk of acute congestive heart failure (OR 1.562, p = 0.029). LOS was significantly longer in Black patients (0.418 days, p < 0.001), while Asian patients had a shorter LOS (-0.246 days, p = 0.03). Conclusions: This study identifies significant racial disparities in MACCE outcomes, mortality, and healthcare utilization among liver cancer patients. Black and Asian patients experienced higher mortality and an increased risk of sudden cardiac arrest, while Hispanic and Asian patients exhibited a lower risk of MI. Differences in LOS underscore healthcare inequities. These findings highlight the need for targeted interventions to address disparities and improve outcomes for racial and ethnic minority populations with liver cancer.