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Objective: Hepatocellular carcinoma (HCC) has an overall 5-year survival of 17.5%, and will lead to an estimated 27,170 deaths in the United States (US) in 2016. Previous evidence suggests that HCC outcomes are worse in Nevada (NV). This research investigated HCC inpatient outcomes, and examined putative HCC etiology and patient demographics for disparities. Methods: Adult inpatient hospitalizations from 2008 to 2012 in NV and the US were retrospectively reviewed using the Nationwide Inpatient Sample and NV State Inpatient Database of the Healthcare Cost and Utilization Project. We identified 60,220 US and 2107 NV hospitalizations with diagnosed HCC using ICD-9-CM codes. Metabolic syndrome (MetS), alcohol use, and viral hepatitis ICD-9-CM codes were used to create putative etiology subgroups (Viral-HCC, MetS-HCC, Alcohol-HCC), a multiple-cause subgroup (Multiple-HCC), and a cryptogenic subgroup (Other-HCC). Weighted logistic regression analyses were conducted using SAS/STAT Ò software version 9.4. Results: Overall-HCC, MetS-HCC, Alcohol-HCC, and Other-HCC accounted for significantly greater hospitalization charges in NV compared to the US (Table 1). Alcohol-HCC and Multiple-HCC had greater mean length of stay (LOS) in NV (Table 1). Other-HCC had lower inhospital mortality in NV (p = 0.045). The US mortality odds ratio was 1.31 for AfricaneAmerican (p < 0.001) and 1.58 for Native American (p = 0.021) compared to Caucasian patients, and 1.84 (p < 0.001) for self-pay compared to Medicare patients. Conclusion: Compared to the US, Nevadan HCC hospitalizations had increased LOS (Alcohol-HCC and Multiple-HCC) and increased total charges (MetS-HCC, Alcohol-HCC, Other-HCC, Overall-HCC). Confirming previous findings, disparities varied by ethnicity and insurance status, highlighting the need for further investigation and population health interventions.

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