Racial disparities in major adverse cardiovascular and cerebrovascular events outcomes among hospitalized cholangiocarcinoma patients.

Abstract

e23097 Background: Cholangiocarcinoma presents significant treatment challenges, with racial and ethnic disparities influencing clinical outcomes. This study analyzes data from the National Inpatient Sample (NIS) from 2016 to 2021 to investigate racial disparities in major adverse cardiovascular and cerebrovascular events outcomes, mortality, and healthcare resource utilization among hospitalized cholangiocarcinoma patients. Methods: A retrospective cohort analysis was performed using the NIS database to identify adult cholangiocarcinoma patients. Demographic and clinical characteristics, including race, age, sex, socioeconomic status, and comorbidities, were compared across racial groups. Key outcomes included in-hospital mortality, myocardial infarction (MI), atrial fibrillation (A-fib), stroke, intracranial hemorrhage, and healthcare resource utilization. Multivariable logistic regression models adjusted for potential confounders to assess racial disparities in these outcomes. Results: Among 139 patients with cholangiocarcinoma, the racial distribution was White (67.4%), Black (10.8%), Hispanic (12.2%), Asian or Pacific Islander (6.2%), Native American (0.6%), and Other (3.6%). Black patients had significantly higher odds of mortality (OR 1.438, p < 0.001) and sudden cardiac arrest (OR 2.159, p < 0.001) compared to White patients. Hispanic patients had a lower risk of MI (OR 0.726, p = 0.046), while Black patients were more likely to experience stroke (OR 1.763, p < 0.001). Atrial fibrillation was significantly less common in Black (OR 0.469, p < 0.001), Hispanic (OR 0.492, p < 0.001), and Asian or Pacific Islander (OR 0.591, p < 0.001) patients. Black patients had the longest LOS compared to White patients (0.942 days, p < 0.001), while Native Americans had significantly longer LOS (1.64 days, p = 0.017). Hispanic and Asian groups had higher total hospital charges compared to White patients ($20,619.25, $18,181.22, and $24,200.53, respectively, p < 0.001). Conclusions: This study highlights significant racial disparities in cholangiocarcinoma outcomes, with Black, Native American, and Other racial groups experiencing higher mortality and adverse cardiovascular events. The lower incidence of MI and A-fib in Hispanic and Asian patients suggests potential protective factors, though disparities in stroke and sudden cardiac arrest persist.