Patients with early-stage alcohol-associated liver disease are at increased risk of hospital readmission and death.

Autor: Aryan M; Division of Gastroenterology and Hepatology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama., Qian S; Division of Gastroenterology and Hepatology, University of Florida College of Medicine., Chen Z; Department of Biostatistics, University of Florida, Gainesville, Florida., Louissaint J; Center for Liver Disease and Liver Transplantation, Columbia University Vagelos College of Physicians and Surgeons., Qian X; Division of Gastroenterology and Hepatology, University of Florida College of Medicine., Rosenblatt R; Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York., Verna E; Center for Liver Disease and Liver Transplantation, Columbia University Vagelos College of Physicians and Surgeons., Brown R; Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York., Wong R; Division of Gastroenterology and Hepatology, Stanford University School of Medicine and Veterans Affairs Palo Alto Healthcare System, Palo Alto, California., Clark V; Division of Gastroenterology and Hepatology, University of Florida College of Medicine., Zhang W; Division of Gastroenterology and Hepatology, University of Florida College of Medicine.; Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2024 Mar 01; Vol. 36 (3), pp. 318-325. Date of Electronic Publication: 2023 Dec 27.
DOI: 10.1097/MEG.0000000000002701
Abstrakt: Background and Aims: Patients with alcohol use disorder (AUD) can develop alcohol-associated fatty liver disease (AFLD). However, the impact of AFLD on outcomes remains unclear. We studied the impact of AFLD on readmission, 30-day mortality, and overall mortality in patients admitted with AUD.
Methods: Hospitalized patients with AUD between 2011 and 2019 at a tertiary medical center were retrospectively evaluated. Our population included patients with AUD with AFLD: AST and ALT elevation and serum bilirubin <3 mg/dl. Patients with AUD without evidence of liver disease served as control and were labeled as no ALD. Patients with alcohol-associated cirrhosis (AC) and alcohol-associated hepatitis (AH) were included for comparison. Kaplan-Meier survival analysis and multivariable regression for predictors of mortality and survival were performed.
Results: There were 7522 patients of which 32.44% were female with mean age of 51.86 ± 14.41 years. Patient distribution included no ALD (n = 3775), AFLD (n = 2192), AC (n = 1017) and AH (n = 538) groups. Compared to no ALD group, AFLD group was associated with significantly higher 30-day mortality [4.43% vs. 1.56%, hazard ratio (HR): 2.84; P  < 0.001], overall mortality [15.97% vs. 12.69%, HR 1.40, P  < 0.001], and 30-day readmission [21.85% vs. 18.49%, odds ratio: 1.21; P  < 0.01].
Conclusion: We demonstrated that AFLD is not a benign entity and poses significant mortality risk. Our results suggest that AFLD may be under-recognized and highlight the need for focused management and close follow-up after discharge.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: