Characteristics and comparative clinical outcomes of prisoner versus non-prisoner populations hospitalized with COVID-19

AbstractPrisons in the United States have become a hotbed for spreading COVID-19 among incarcerated individuals. COVID-19 cases among prisoners are on the rise, with more than 143,000 confirmed cases to date. However, there is paucity of data addressing clinical outcomes and mortality in prisoners hospitalized with COVID-19. An observational study of all patients hospitalized with COVID-19 between March 10 and May 10, 2020 at two Henry Ford Health System hospitals in Michigan. Clinical outcomes were compared amongst hospitalized prisoners and non-prisoner patients. The primary outcomes were intubation rates, in-hospital mortality, and 30-day mortality. Multivariable logistic regression and Cox-regression models were used to investigate primary outcomes. Of the 706 hospitalized COVID-19 patients (mean age 66.7 ± 16.1 years, 57% males, and 44% black), 108 were prisoners and 598 were non-prisoners. Compared to non-prisoners, prisoners were more likely to present with fever, tachypnea, hypoxemia, and markedly elevated inflammatory markers. Prisoners were more commonly admitted to the intensive care unit (ICU) (26.9% vs. 18.7%), required vasopressors (24.1% vs. 9.9%), and intubated (25.0% vs. 15.2%). Prisoners had higher unadjusted inpatient mortality (29.6% vs. 20.1%) and 30-day mortality (34.3% vs. 24.6%). In the adjusted models, prisoner status was associated with higher in-hospital death (odds ratio, 2.32; 95% confidence interval (CI), 1.33 to 4.05) and 30-day mortality (hazard ratio, 2.00; 95% CI, 1.33 to 3.00). In this cohort of hospitalized COVID-19 patients, prisoner status was associated with more severe clinical presentation, higher rates of ICU admissions, vasopressors requirement, intubation, in-hospital mortality, and 30-day mortality.

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Comparative Clinical Outcomes and Mortality in Prisoner and Non-Prisoner Populations Hospitalized with COVID-19: A Cohort from Michigan

10.1101/2020.08.08.20170787 ◽

2020 ◽

Author(s):

Ahmed M Altibi ◽

Pallavi Bhargava ◽

Hassan Liaqat ◽

Alexander A. Slota ◽

Radhika Sheth ◽

...

Keyword(s):

Hospital Mortality ◽

Clinical Outcomes ◽

Regression Models ◽

Cox Regression ◽

The United States ◽

Hospital Death ◽

Inpatient Mortality ◽

Mortality Hazard ◽

Henry Ford ◽

Mortality Hazard Ratio

Background: Prisons in the United States have become a hotbed for spreading Covid-19 among incarcerated individuals. Covid-19 cases among prisoners are on the rise, with more than 46,000 confirmed cases to date. However, there is paucity of data addressing clinical outcomes and mortality in prisoners hospitalized with Covid-19. Methods: An observational study of all patients hospitalized with Covid-19 between March 10 and May 10, 2020 at two Henry Ford Health System hospitals in Michigan. Clinical outcomes were compared amongst hospitalized prisoners and non-prisoner patients. The primary outcomes were intubation rates, in-hospital mortality, and 30-day mortality. Multivariable logistic regression and Cox-regression models were used to investigate primary outcomes. Results: Of the 706 hospitalized Covid-19 patients (mean age 66.7 +/- 16.1 years, 57% males, and 44% black), 108 were prisoners and 598 were non-prisoners. Compared to non-prisoners, prisoners were more likely to present with fever, tachypnea, hypoxemia, and markedly elevated inflammatory markers. Prisoners were more commonly admitted to the intensive care unit (ICU) (26.9% vs. 18.7%), required vasopressors (24.1% vs. 9.9%), and intubated (25.0% vs. 15.2%). Prisoners had higher unadjusted inpatient mortality (29.6% vs. 20.1%) and 30-day mortality (34.3% vs. 24.6%). In the adjusted models, prisoner status was associated with higher in-hospital death (odds ratio, 1.95; 95% confidence interval (CI), 1.07 to 3.57) and 30-day mortality (hazard ratio, 1.92; 95% CI, 1.24 to 2.98). Conclusions: In this cohort of hospitalized Covid-19 patients, prisoner status was associated with more severe clinical presentation, higher rates of ICU admissions, vasopressors requirement, intubation, in-hospital mortality, and 30-day mortality.

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Health disparities experienced by Black Americans with multiple myeloma in the United States: A population-based study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18512 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18512-e18512

Author(s):

Samer Al Hadidi ◽

Deepa Dongarwar ◽

Hamisu Salihu ◽

Rammurti T. Kamble ◽

Premal D. Lulla ◽

...

Keyword(s):

Multiple Myeloma ◽

Hospital Mortality ◽

Hematologic Malignancy ◽

Temporal Trends ◽

Black Americans ◽

The United States ◽

Care Utilization ◽

Hospital Death ◽

Inpatient Mortality ◽

Palliative Care Consultation

e18512 Background: Multiple Myeloma (MM) is the most common hematologic malignancy in Black Americans. Incidence and death rates for MM in Black Americans are more than double those in Whites. Our study aimed to evaluate trends of all cause in-hospital mortality among Black Americans with MM and to investigate characteristics of MM-related hospitalizations. Methods: We conducted a retrospective cross-sectional study of hospitalizations in adult patients with MM during 2008-2017 using the National Inpatient Sample (NIS), the largest all-payer inpatient care database in the US. We used joinpoint regression to assess temporal trends in the national incidence of in-hospital death. We conducted adjusted survey logistic regression to generate adjusted odds ratios to measure the likelihood of in-hospital death among MM related hospitalizations. Results: Admissions related to MM constituted 0.32% of all hospitalizations in the study period (913,967 out of 285,876,821). The prevalence of MM related hospitalizations was higher in Black Americans when compared with Whites (476.0 vs 305.6 per 100,000 hospitalizations, p <0.01). In-hospital mortality with MM was higher in older patients, males, those belonging to lowest zip code quartile, and who self-paid for their treatment. Average Annual Percent Change (AAPC) showed a statistically significant decline of in-hospital mortality among all MM patients except Black Americans who had the highest inpatient mortality in 2016 and 2017. Black Americans received less autologous stem cell transplantation (ASCT) (2.8% vs. 3.8%, p <0.01), more blood product transfusions (23.0% vs. 21.1%, p <0.01), less palliative care consultation (4.0% vs. 4.6%, p <0.01), less chemotherapy (10.8% vs. 11.2%, p <0.01), and more intensive care utilization (5.3% vs. 4.3%, p <0.01), when compared with Whites. Adjusted association between race/ethnicity and various outcomes confirmed observed differences [Table]. Conclusions: Black Americans with MM had the slowest improvement and highest inpatient mortality in recent years. Data suggests higher disease burden, more frequent hospitalizations, delay in accessing care and lower utilization of supportive care measures compared with White MM patients. Data highlight disparities in MM care for Black Americans necessitating a clarion call for urgent changes in health care systems.[Table: see text]

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The short-term prognostic value of serum platelet to hemoglobin in patients with type A acute aortic dissection

Perfusion ◽

10.1177/0267659120982226 ◽

2020 ◽

pp. 026765912098222

Author(s):

Yu Wang ◽

Tengfei Qiao ◽

Jun Zhou

Keyword(s):

Aortic Dissection ◽

Hospital Mortality ◽

Acute Aortic Dissection ◽

Independent Predictor ◽

Type A ◽

Short Term ◽

Survivor Group ◽

Mortality Hazard ◽

Mortality Hazard Ratio ◽

The Ideal

Purpose: Type A acute aortic dissection (AAD) is an uncommon catastrophic cardiovascular disease with high pre-hospital mortality rate without timely and effectively treated. The aim of this study was to assess the value of serum platelet to hemoglobin (PHR) in predicting in-hospital mortality in type A AAD patients. Methods: A total of 183 type A AAD patients were included in this retrospective investigation from January 2017 to December 2019. Admission blood routine parameters were gathered and PHR was computed. The outcome was all-cause in-hospital mortality within 30 days. Results The average levels of serum PHR were significant higher in survivor group than those in non-survivor group (1.14 ± 0.57 vs 0.87 ± 0.47, p = 0.006) and serum PHR was an independent factor associated with in-hospital mortality (hazard ratio (HR): 2.831; 95% confidence interval (CI): 1.108–7.231; p = 0.030). ROC noted that 0.8723 was chosen as the ideal cutoff value with a sensitivity of 64.3% and specificity of 72.5%. In addition, the area under the ROC curve (AUC) was 0.693 (95% CI 0.599–0.787, p < 0.001). Conclusion: Admission serum PHR can be used as an independent predictor of in-hospital mortality in patients with type A AAD.

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Stopping 5-aminosalicylates in patients with ulcerative colitis starting biologic therapy does not increase the risk of adverse clinical outcomes: analysis of two nationwide population-based cohorts

Gut ◽

10.1136/gutjnl-2018-317021 ◽

2018 ◽

Vol 68 (6) ◽

pp. 977-984 ◽

Cited By ~ 19

Author(s):

Ryan C Ungaro ◽

Berkeley N Limketkai ◽

Camilla Bjørn Jensen ◽

Kristine Højgaard Allin ◽

Manasi Agrawal ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Outcomes ◽

Cox Regression ◽

The United States ◽

Health Claims ◽

Sensitivity Analyses ◽

Clinical Event ◽

Clinical Events ◽

Increased Risk ◽

National Databases

ObjectiveThe benefit of continuing 5-aminosalicylate (5-ASA) in patients with ulcerative colitis (UC) who initiate anti-tumour necrosis factor-alpha (anti-TNF) biologics is unknown. We aimed to compare clinical outcomes in patients with UC already on 5-ASA who started anti-TNF and then either stopped or continued 5-ASA.DesignOur primary outcome was any adverse clinical event defined as a composite of new corticosteroid use, UC-related hospitalisation or surgery. We used two national databases: the United States (US) Truven MarketScan health claims database and the Danish health registers. Patients with UC who started anti-TNF after having been on oral 5-ASA for at least 90 days were included. Patients were classified as stopping 5-ASA if therapy was discontinued within 90 days of starting anti-TNF. We performed multivariable Cox regression models controlling for demographics, clinical factors and healthcare utilisation. Adjusted HRs (aHR) with 95% CI are reported comparing stopping 5-ASA with continuing 5-ASA.ResultsA total of 3589 patients with UC were included (2890 US and 699 Denmark). Stopping 5-ASA after initiating anti-TNF was not associated with an increased risk of adverse clinical events in the U.S. cohort (aHR 1.04; 95% CI 0.90 to 1.21, p=0.57) nor in the Danish cohort (aHR 1.09; 95% CI 0.80 to 1.49, p=0.60). Results were similar in sensitivity analyses investigating concomitant immunomodulator use and duration of 5-ASA treatment before initiating anti-TNF.ConclusionIn two national databases, stopping 5-ASA in patients with UC starting anti-TNF therapy did not increase the risk of adverse clinical events. These results should be validated in a prospective clinical trial.

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Using Data Analytics to Predict Hospital Mortality in Sepsis Patients

International Journal of Healthcare Information Systems and Informatics ◽

10.4018/ijhisi.2019070104 ◽

2019 ◽

Vol 14 (3) ◽

pp. 40-57

Author(s):

Yazan Alnsour ◽

Rassule Hadidi ◽

Neetu Singh

Keyword(s):

Hospital Mortality ◽

Predictive Model ◽

Health Care Providers ◽

Prediction Models ◽

Predictive Analytics ◽

Area Under The Curve ◽

The United States ◽

Hospital Death ◽

Care Providers ◽

Chi Square

Predictive analytics can be used to anticipate the risks associated with some patients, and prediction models can be employed to alert physicians and allow timely proactive interventions. Recently, health care providers have been using different types of tools with prediction capabilities. Sepsis is one of the leading causes of in-hospital death in the United States and worldwide. In this study, the authors used a large medical dataset to develop and present a model that predicts in-hospital mortality among Sepsis patients. The predictive model was developed using a dataset of more than one million records of hospitalized patients. The independent predictors of in-hospital mortality were identified using the chi-square automatic interaction detector. The authors found that adding hospital attributes to the predictive model increased the accuracy from 82.08% to 85.3% and the area under the curve from 0.69 to 0.84, which is favorable compared to using only patients' attributes. The authors discuss the practical and research contributions of using a predictive model that incorporates both patient and hospital attributes in identifying high-risk patients.

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Exposure To ABO Compatible But Non-Group Identical Blood and In-Hospital Mortality

Blood ◽

10.1182/blood.v122.21.3651.3651 ◽

2013 ◽

Vol 122 (21) ◽

pp. 3651-3651

Author(s):

Richard J Cook ◽

Nancy Heddle ◽

Ker-Ai Lee ◽

Yang Liu ◽

Rebecca Barty, MLT ◽

...

Keyword(s):

Hospital Mortality ◽

Research Funding ◽

Cox Regression ◽

Type A ◽

Blood Type ◽

Hospital Death ◽

Trauma Patients ◽

Factors Associated ◽

Blood Types ◽

Increased Risk

Abstract Background Transfusions that are ABO compatible but not group identical (mismatched) are given for a variety of reasons including inventory availability, avoiding wastage from outdating, and clinical urgency. A recent observation at our centre suggested that patient outcome was different for those patients that received a transfusion of units with a compatible but mismatched ABO group compared to those receiving ABO group identical blood. Hence, we performed a retrospective hospital registry study to explore the association between mismatched blood and in-hospital mortality in transfused patients. Study Design Our patient/blood utilization database included 35,487 transfused hospitalized patients from 3 acute care academic centres from April 1, 2002 to October 31, 2011. Information on transfused RBCs included duration of storage (days) and ABO type. Patient data included: sex; age; hemoglobin; creatinine; diagnosis; interventions; ABO blood group and hospital discharge status. Factors associated with mismatched blood and in-hospital mortality were examined using generalized estimating equations to account for the potential serial dependence over multiple transfusions. The effect of exposure to ABO mismatched blood on in-hospital death was examined through Cox regression with time-dependent strata defined by: year of first admission; disease group; and the cumulative number of units transfused (≤ 7 days of storage; > 7 days but ≤ 28 days storage; and, >28 days of storage); and, controlling for available baseline and time-varying characteristics. Results 18,843 patients (blood groups A, B and AB), with complete covariates contributed to the analysis. Factors associated with transfusion of mismatched blood included: younger patient age (p<0.0001); lower hemoglobin (p<0.0001); higher creatinine (p<0.0001); intervention during hospitalization (OR=4.6, p<0.0001); and, patient ABO group whereby blood types A and B were much less likely to receive a mismatched unit compared to type AB patients (p<0.0001). There was a statistically significant interaction between patient blood type and the effect of receiving mismatched blood (p=0.034) with type A patients incurring a 79% higher risk of death (RR=1.79, 95% CI: 1.20, 2.67; p=0.0047); other patient blood types did not suggest increased risk. Similar results were observed when suspected trauma patients (≥ 6 units within 24 hours) were excluded from the analysis (Table 1). Conclusion Controlling for known potential confounders through Cox regression yielded evidence of increased risk of in-hospital mortality among blood type A patients receiving group O red cells. This association remained after suspected trauma patients were excluded from the analyses. Further study of the association observed in this study is warranted. Disclosures: Cook: CIHR: Research Funding. Heddle:CIHR: Research Funding; Canadian Blood Services: Membership on an entity’s Board of Directors or advisory committees, Research Funding; Health Canada: Research Funding. Eikelboom:CIHR: Research Funding.

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Evolution of clinical outcomes of metastatic pancreatic adenocarcinoma: A 10-year single-institution retrospective study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16760 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16760-e16760

Author(s):

Moataz Ellithi ◽

Mohamed A. Abdallah ◽

Mahum Shahid ◽

Isaak Ailts ◽

Kate Waligoske ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Outcomes ◽

Pancreatic Adenocarcinoma ◽

Cox Regression ◽

The United States ◽

Wilcoxon Test ◽

Cox Regression Analysis ◽

Metastatic Pancreatic Adenocarcinoma ◽

Significant Difference ◽

Before And After

e16760 Background: Pancreatic adenocarcinoma represents the fourth leading cause of cancer-related death in the United States. A majority of patients have locally advanced or metastatic disease at the time of diagnosis. For many years, gemcitabine monotherapy was the standard of care for advanced disease, until recent studies demonstrated survival benefits for FOLFIRINOX (5-FU, leucovorin, irinotecan, and oxaliplatin) and Gem/nab-P (gemcitabine/nab-paclitaxel). In this study, we evaluated the clinical outcomes in patients with metastatic pancreatic adenocarcinoma in a single health system before and after the incorporation of these newer treatments into practice. Methods: A retrospective study of metastatic pancreatic adenocarcinoma patients diagnosed between January 2009 to December 2018 with follow up until December 2019. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier survival analysis. Univariate and multivariable Cox regression analyses were used to explore predictors of survival. Results: 394 patients were diagnosed with metastatic pancreatic adenocarcinoma at Sanford Health hospitals during the study period. There was no statistically significant difference in OS between the cohort diagnosed between 2009-2013 compared to 2014-2018, with median OS of 4.7 and 3.6 months respectively; in those receiving at least one line of chemotherapy, the median OS was 6.7 and 7.3 months. While subgroup analysis of all study population based on the type of first-line chemotherapy showed improved survival with FOLFIRINOX and Gem/nabP as compared to gemcitabine monotherapy [10.7, 6.9, 4 months respectively] (Wilcoxon Test of Homogeneity of Survival Curves p = 0.0002). Univariate and multivariate Cox regression analysis of all study data revealed that at the time of the diagnosis, age (HR: 1.021, p = 0.0013), ECOG performance status > 1 (HR: 3.47, p = 0.0001), serum albumin (HR: 0.708, p = 0.0002), Neutrophil-to-Lymphocytes ratio (HR: 1.076, p≤0.0001) and platelets-to-lymphocyte ratio (HR: 0.998, p = 0.0031) were predictors of survival. Conclusions: Although newer treatments appear to offer improved survival for eligible patients, overall outcomes for metastatic pancreatic adenocarcinoma in this cohort were similar before and after the incorporation of newer treatment regimens. Further advances in the treatment and early detection of pancreatic cancer are needed to improve clinical outcomes.

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In-hospital mortality following carotid endarterectomy

Neurology ◽

10.1212/wnl.51.2.440 ◽

1998 ◽

Vol 51 (2) ◽

pp. 440-447 ◽

Cited By ~ 16

Author(s):

Douglas J. Lanska ◽

Richard J. Kryscio

Keyword(s):

Hospital Mortality ◽

Carotid Endarterectomy ◽

Surgical Complications ◽

Surgical Complication ◽

The United States ◽

Population Based ◽

Third Party ◽

Hospital Death ◽

Stepwise Logistic Regression ◽

Secondary Procedure

Objectives: To determine population-based estimates of in-hospital mortality following carotid endarterectomy (CEA) and identify potential risk factors for in-hospital death.Methods: Data from the Healthcare Cost and Utilization Project (HCUP-3) were analyzed for the year 1993. Nationally representative estimates of risk were calculated by age, sex, race, income, census region, hospital location (urban versus rural), teaching status of hospital, number of hospital beds, hospital ownership, third-party payer, principal procedure, and presence of surgical complications. Multivariate models were developed using stepwise logistic regression and a logit model fit by generalized estimating equations.Results: There were 228 deaths among 18,510 CEAs performed in 17 states of the United States in 1993, yielding an estimated in-hospital mortality rate of 1.2%. Multivariate analysis showed that age, principal procedure, and presence of any surgical complication were significant predictors of in-hospital mortality increased with increasing age (from 0.9% in those younger than 65 years to 1.7% in those age 75 and older) and was markedly higher with CEA performed as a secondary procedure (6.1% versus 0.9%) or with any surgical complication (5.9% versus 0.9%).Conclusions: Increasing age, CEA performed as a secondary procedure, and surgical complications are important predictors of in-hospital mortality following CEA.

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Renal dysfunction in patients with pulmonary embolism: data from the SIRENA register

Russian Journal of Cardiology ◽

10.15829/1560-4071-2021-4422 ◽

2021 ◽

Vol 26 (2S) ◽

pp. 4422

Author(s):

M. V. Menzorov ◽

V. V. Filimonova ◽

A. D. Erlikh ◽

O. L. Barbarash ◽

S. A. Berns ◽

...

Keyword(s):

Pulmonary Embolism ◽

High Risk ◽

Risk Stratification ◽

Hospital Mortality ◽

Renal Dysfunction ◽

Cox Regression ◽

Russian Population ◽

Hospital Death ◽

Death Risk ◽

Risk Of Death

Aim. To assess the prevalence, severity and prognostic value of renal dysfunction (RD) in patients with pulmonary embolism (PE) of the Russian population, as well as to determine the RD significance as a marker that improves the predictive ability of current risk stratification systems.Material and methods. From April 2018 to April 2019, patients hospitalized due to PE were sequentially included in the Russian multicenter observational prospective registry SIRENA. RD was diagnosed at a glomerular filtration rate (GFR) <60 ml/ min/1,73 m2. Risk of early (hospital or 30-day) death was stratified in accordance with the current 2019 ESC Clinical Guidelines. During the study, we analyzed inpatient mortality and complication rate.Results. A total of 604 patients (men, 293 (49%); women, 311 (51%)) were in the study. RD was detected in 320 (53%) patients, while severe dysfunction — in 63 (10%) ones. In addition, 71 (12%) patients had high death risk, 364 (61%) — intermediate, 164 (27%) — low. During hospitalization, 107 (18%) patients died, including 32% from the high-risk group, 20% — moderate, and 7% — low. RD in the deceased patients was diagnosed more often, while GFR <50 ml/min/1,73 m2 reliably predicted hospital mortality (sensitivity, 67%; specificity, 72%; AUC=0,72; p<0,001). In patients with simplified Pulmonary Embolism Severity Index (sPESI) of 0 and ≥ 1, the presence of RD led to at least a 2-fold increase in mortality. Multivariate Cox regression revealed that RD is a predictor of in-hospital mortality (hazard ratio (HR), 3,41; 95% confidence interval (CI): 2,15-5,41; p<0,001), regardless of the presence of death risk reclassifies, such as high troponin (HR, 1,31; 95% CI: 0,80-2,14; p=0,28) and right ventricular dysfunction (HR, 1,23; 95% CI: 0,74-2,04; p=0,42).Conclusion. In patients with PE of the Russian population, there is a high incidence of RD, which is diagnosed in every second patient and is severe in 10% of cases. The presence of RD is associated with a significant increase in in-hospital mortality, while the risk of death increases with a decrease in GFR. The addition of RD, considered as a decrease in the estimated GFR <60 ml/min/1,73 m2, to the sPESI improves risk stratification and allows identification of patients at high risk of in-hospital death.

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Ethnic Disparities in AL Amyloidosis Outcomes Among Hospitalized Patients in the United States

Blood ◽

10.1182/blood-2021-147060 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 4110-4110

Author(s):

Samer Al Hadidi ◽

Deepa Dongarwar ◽

Hamisu Salihu ◽

Carolina Schinke ◽

Sharmilan Thanendrarajan ◽

...

Keyword(s):

Palliative Care ◽

Health Disparities ◽

Hospital Mortality ◽

Conflicts Of Interest ◽

The United States ◽

Hospital Death ◽

Al Amyloidosis ◽

Type I ◽

Care Services ◽

Palliative Care Services

Abstract INTRODUCTION Health disparities in immunoglobulin light chain (AL) amyloidosis have not been well described. We aimed to assess if health disparities between non-Hispanic (NH)-Whites, NH-Blacks and Hispanics exist and to describe differences between different ethnic/racial groups. METHODS We conducted a retrospective cross-sectional analysis of in-patient AL amyloidosis hospitalizations from 2016 to 2018 using the Nationwide Inpatient Sample (NIS), a database which provides nationally representative information on hospitalizations in the U.S. The studied period was chosen to capture data from the ICD-10-CM codes to avoid misclassification of AL amyloidosis which was grouped with other cases of ATTR amyloidosis in the ICD-9-CM coding system. All hospitalizations in adults (age ≥18 years) were included. The exposure for the study was the occurrence of AL amyloidosis in the discharge records. Outcomes were [1] in-hospital death [2] chemotherapy use; [3] intensive care unit (ICU) utilization; [4] palliative care consultation. The analysis for this study was performed using R program version 3.5.1; a 5% type I error rate for all hypothesis tests (two-sided) was assumed. RESULTS Admissions related to AL amyloidosis constituted 0.03% of all hospitalizations in the study period (25,470 of 90,869,381). The prevalence of AL amyloidosis related hospitalizations was higher in NH-Blacks when compared with NH-Whites (42.8 vs.28.1 per 100,000 hospitalizations). AL amyloidosis related in-hospital mortality rate was higher in NH-Whites and Hispanics when compared to NH-Blacks (6.6%% and 6.2% vs. 4.9%). In-hospital mortality with AL amyloidosis was higher in older patients, males and those who self-paid for their treatment. Utilization of ICU care was more common in NH-Blacks when compared to NH-Whites (6% vs. 4.8%). Hispanics had the lowest inpatient chemotherapy use (1.7% vs. 2.9%). Multivariable adjusted association between race/ethnicity and various outcomes showed a trend towards lower in-hospital mortality in NH-Blacks when compared to NH-Whites (OR: 0.76, 95% CI: 0.55-1.05, p=0.09) and lower utilization of palliative care services in NH-Blacks when compared with NH-Whites (OR: 0.61, 95% CI: 0.42-0.88, p=0.01). Despite very low numbers of transplant related admissions, such admissions occurred only in NH-Whites. CONCLUSIONS Our findings highlight disparities in AL amyloidosis care for NH-Blacks and Hispanics. NH-Blacks tend to have lower in-hospital mortality with higher utilization of ICU care, nevertheless, they receive the lowest palliative care services. Despite the higher utilization of ICU care, data suggest possible superior outcomes of AL amyloidosis in NH-Blacks when compared to NH-Whites. Disclosures No relevant conflicts of interest to declare.

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