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Outcomes of Patients Hospitalized for Severe Acute Alcoholic Hepatitis.

Authors
  • Noronha, Leonard1
  • FitzGerald, Erin1
  • Pierce, J Rush Jr1
  • 1 From the Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque. , (Mexico)
Type
Published Article
Journal
Southern Medical Journal
Publisher
Southern Medical Association
Publication Date
Jul 01, 2019
Volume
112
Issue
7
Pages
363–368
Identifiers
DOI: 10.14423/SMJ.0000000000000999
PMID: 31282964
Source
Medline
Language
English
License
Unknown

Abstract

Severe acute alcoholic hepatitis is a serious condition in individuals who consume significant quantities of alcohol. We aimed to identify risk factors for short-term mortality with this illness. Patients with severe acute alcoholic hepatitis admitted to our academic medical center from 2010 to 2012 were identified. Demographic features, laboratory values, and patient outcomes were recorded. In-hospital mortality and transfer to inpatient hospice were combined to calculate overall inpatient mortality. A total of 251 hospitalizations of 191 patients were identified. The average age was 43.1 years (standard deviation 9.55). Most patients were men (80.6%). Compared with all adult patients admitted to internal medicine services during the same period, patients self-reporting Native American and Hispanic race/ethnicity were overrepresented (11.1% vs 34.0% and 14.8% vs 27.7%, χ2 P < 0.0001). In-hospital mortality was 20.3%. Another 10% of patients were transferred to inpatient hospice facilities. In the multivariate analysis, higher overall inpatient mortality was associated with an admission bilirubin >20 mg/dL (odds ratio 4.59). Of the patients, 11.9% were readmitted with a complication within 30 days-most commonly septic shock. Of the readmitted patients, the overall inpatient mortality was 86.2%. This study confirms the severity of illness among patients with severe acute alcoholic hepatitis. Patients with the highest total bilirubin levels on admission had the highest overall inpatient mortality. Readmission was a strong predictor of overall in-hospital mortality.

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