Age and Ethnicity in Cirrhosis

• Published in: Journal of investigative medicine Vol. 62; no. 7; pp. 920 - 926
• Main Authors: Sajja, Krishna C., Mohan, Desh P., Rockey, Don C.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2014; Sage Publications Ltd
• Subjects: Adult; Age; Age Distribution; Age Factors; Aged; Aged, 80 and over; Alcohol; Black or African American; Cytokines; Ethnicity; Female; Health care access; Hepatitis; Hispanic or Latino; Histology; Hospital systems; Hospitalization; Hospitals; Humans; Hypertension; Laboratories; Liver cirrhosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - ethnology; Liver Cirrhosis - etiology; Liver diseases; Male; Middle Aged; Mortality; Proteins; Rodents; Statistical analysis; Studies; United States - epidemiology; Variables; White People; Young Adult; United States; United States > US; nonalcoholic steatohepatitis; alcohol; race; hepatitis; Hispanic; African American
• ISSN: 1081-5589; 1708-8267
• DOI: 10.1097/JIM.0000000000000106

BackgroundCirrhosis 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.MethodsIn 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.ResultsWe 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).ConclusionsThe 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.