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Age and Ethnicity in Cirrhosis
  1. Krishna C. Sajja, BS*,
  2. Desh P. Mohan, BS*,
  3. Don C. Rockey, MD
  1. From the *Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center and Parkland Memorial Hospital, Dallas, TX; and †Department of Internal Medicine, Medical University of South Carolina, Charleston, SC.
  1. Received January 30, 2014, and in revised form June 1, 2014.
  2. Accepted for publication July 22, 2014.
  3. Reprints: Don C. Rockey, MD, Department of Internal Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, Suite 803, MSC 623, Charleston, SC 29425. E-mail: rockey{at}musc.edu.
  4. Supported in part by the National Institutes of Health grant R01 DK 57830 to D.C.R. and an institutional grant (number 5T35DK066141).
  5. Author contributions: Krishna C. Sajja contributed to the study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, and statistical analysis. Desh P. Mohan contributed to the study concept and design and the acquisition of data. Don C. Rockey contributed to the study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.
  6. Conflict of interest disclosure: The authors certify that we have no financial arrangements (eg, consultancies, stock ownership, equity interests, patent-licensing arrangements, research support, major honoraria) with a company whose product figures prominently in this study or with a company making a competing product.

Abstract

Background Cirrhosis is diagnosed in patients of all ages and is the end result of many different diseases. The aim of this study was to characterize clinical and ethnic features of adult patients who were admitted to the hospital at different (young/old) ages and examine associations between age and ethnicity within these groups.

Methods In this retrospective analysis of a diverse cohort of 2017 patients with a clinical diagnosis of cirrhosis between January 2001 and December 2011, we focused on age, ethnicity, and outcome of patients with cirrhosis.

Results We identified 219 patients younger than the age of 40 years, including 87 (11%) of 802 white, 31 (6%) of 550 African American, and 89 (16%) of 550 Hispanic patients (P < 0.001). Ethnicity and causes of cirrhosis were found to have a significant correlation with age. Overall, Hispanic and white patients together were more than twice as likely to be diagnosed with cirrhosis at an age younger than 40 years compared with African American patients (P < 0.001). Autoimmune hepatitis caused cirrhosis at a younger age regardless of ethnicity (P < 0.001), whereas cryptogenic/nonalcoholic fatty liver disease/nonalcoholic steatohepatitis was more likely identified at an older age (P = 0.008). African American patients with cirrhosis due to either alcohol or hepatitis C virus were older than Hispanic (P < 0.001 and P = 0.003, respectively) and white patients (P < 0.001 and P < 0.001, respectively) at presentation. Finally, younger patients admitted with cirrhosis had a higher in-hospital mortality rate (P < 0.001).

Conclusions The data suggest an association between ethnicity and age of cirrhosis diagnosis, both overall and in patients with certain cirrhosis etiologies. This work raises the possibility of an ethnic and/or genetic basis for cirrhosis.

Key Words
  • nonalcoholic steatohepatitis
  • hepatitis
  • alcohol
  • Hispanic
  • African American
  • race

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