Clinical characteristics and mortality of hospitalized alcoholic hepatitis patients in the United States

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Abstract

Background and aims: Alcoholic hepatitis (AH) is the most florid manifestation of alcoholic liver disease. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized AH patients in the United States using the 2007 Nationwide inpatient sample of the Healthcare Cost and Utilization Project. Methods: Patients who were hospitalized with the primary diagnosis of AH in the United States in 2007 were identified using International Classification of Diseases-9 code. We further characterized these subjects based on associated symptoms (such as ascites, hepatic encephalopathy, and coagulopathy), complications during hospitalization (such as sepsis, pneumonia, spontaneous bacterial peritonitis, and acute renal failure), and categories pertaining to hospital characteristics, such as teaching status. The predictors of mortality were calculated using logistic regression analyses. Results: There were 8,043,415 in-patient admissions, of which 56,809 (0.71%) were hospitalized with the primary diagnosis of AH. The mean age was 53.2 years, and 27% were female. The average length of stay was 6.5±7.7 days and 3,881 subjects (6.8%) died during hospitalization. Medicare and Medicaid were the main primary expected payer sources (51.8%) with the average total charges during hospital stay of $37,769. In the multivariate analyses, older age, presence of sepsis, spontaneous bacterial peritonitis, pneumonia, urinary tract infection, acute renal failure, hepatic encephalopathy, and coagulopathy were independently associated with in-patient mortality. Conclusions: In-hospital mortality rate for AH remains high, especially in those with infectious complications, hepatic encephalopathy, coagulopathy, and acute renal failure. Our analysis documented significant healthcare cost and utilization among hospitalized AH patients.

Original languageEnglish
Pages (from-to)714-719
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume45
Issue number8
DOIs
StatePublished - Sep 2011

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Alcoholic Hepatitis
Hepatic Encephalopathy
Mortality
Acute Kidney Injury
Bacterial Pneumonia
Peritonitis
Health Care Costs
Length of Stay
Sepsis
Hospitalization
Alcoholic Liver Diseases
Patient Admission
Medicaid
International Classification of Diseases
Medicare
Hospital Mortality
Ascites
Urinary Tract Infections
Inpatients
Teaching

Keywords

  • alcoholic hepatitis
  • in-hospital mortality
  • NIS data

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Clinical characteristics and mortality of hospitalized alcoholic hepatitis patients in the United States",
abstract = "Background and aims: Alcoholic hepatitis (AH) is the most florid manifestation of alcoholic liver disease. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized AH patients in the United States using the 2007 Nationwide inpatient sample of the Healthcare Cost and Utilization Project. Methods: Patients who were hospitalized with the primary diagnosis of AH in the United States in 2007 were identified using International Classification of Diseases-9 code. We further characterized these subjects based on associated symptoms (such as ascites, hepatic encephalopathy, and coagulopathy), complications during hospitalization (such as sepsis, pneumonia, spontaneous bacterial peritonitis, and acute renal failure), and categories pertaining to hospital characteristics, such as teaching status. The predictors of mortality were calculated using logistic regression analyses. Results: There were 8,043,415 in-patient admissions, of which 56,809 (0.71{\%}) were hospitalized with the primary diagnosis of AH. The mean age was 53.2 years, and 27{\%} were female. The average length of stay was 6.5±7.7 days and 3,881 subjects (6.8{\%}) died during hospitalization. Medicare and Medicaid were the main primary expected payer sources (51.8{\%}) with the average total charges during hospital stay of $37,769. In the multivariate analyses, older age, presence of sepsis, spontaneous bacterial peritonitis, pneumonia, urinary tract infection, acute renal failure, hepatic encephalopathy, and coagulopathy were independently associated with in-patient mortality. Conclusions: In-hospital mortality rate for AH remains high, especially in those with infectious complications, hepatic encephalopathy, coagulopathy, and acute renal failure. Our analysis documented significant healthcare cost and utilization among hospitalized AH patients.",
keywords = "alcoholic hepatitis, in-hospital mortality, NIS data",
author = "Suthat Liangpunsakul",
year = "2011",
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doi = "10.1097/MCG.0b013e3181fdef1d",
language = "English",
volume = "45",
pages = "714--719",
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T1 - Clinical characteristics and mortality of hospitalized alcoholic hepatitis patients in the United States

AU - Liangpunsakul, Suthat

PY - 2011/9

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N2 - Background and aims: Alcoholic hepatitis (AH) is the most florid manifestation of alcoholic liver disease. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized AH patients in the United States using the 2007 Nationwide inpatient sample of the Healthcare Cost and Utilization Project. Methods: Patients who were hospitalized with the primary diagnosis of AH in the United States in 2007 were identified using International Classification of Diseases-9 code. We further characterized these subjects based on associated symptoms (such as ascites, hepatic encephalopathy, and coagulopathy), complications during hospitalization (such as sepsis, pneumonia, spontaneous bacterial peritonitis, and acute renal failure), and categories pertaining to hospital characteristics, such as teaching status. The predictors of mortality were calculated using logistic regression analyses. Results: There were 8,043,415 in-patient admissions, of which 56,809 (0.71%) were hospitalized with the primary diagnosis of AH. The mean age was 53.2 years, and 27% were female. The average length of stay was 6.5±7.7 days and 3,881 subjects (6.8%) died during hospitalization. Medicare and Medicaid were the main primary expected payer sources (51.8%) with the average total charges during hospital stay of $37,769. In the multivariate analyses, older age, presence of sepsis, spontaneous bacterial peritonitis, pneumonia, urinary tract infection, acute renal failure, hepatic encephalopathy, and coagulopathy were independently associated with in-patient mortality. Conclusions: In-hospital mortality rate for AH remains high, especially in those with infectious complications, hepatic encephalopathy, coagulopathy, and acute renal failure. Our analysis documented significant healthcare cost and utilization among hospitalized AH patients.

AB - Background and aims: Alcoholic hepatitis (AH) is the most florid manifestation of alcoholic liver disease. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized AH patients in the United States using the 2007 Nationwide inpatient sample of the Healthcare Cost and Utilization Project. Methods: Patients who were hospitalized with the primary diagnosis of AH in the United States in 2007 were identified using International Classification of Diseases-9 code. We further characterized these subjects based on associated symptoms (such as ascites, hepatic encephalopathy, and coagulopathy), complications during hospitalization (such as sepsis, pneumonia, spontaneous bacterial peritonitis, and acute renal failure), and categories pertaining to hospital characteristics, such as teaching status. The predictors of mortality were calculated using logistic regression analyses. Results: There were 8,043,415 in-patient admissions, of which 56,809 (0.71%) were hospitalized with the primary diagnosis of AH. The mean age was 53.2 years, and 27% were female. The average length of stay was 6.5±7.7 days and 3,881 subjects (6.8%) died during hospitalization. Medicare and Medicaid were the main primary expected payer sources (51.8%) with the average total charges during hospital stay of $37,769. In the multivariate analyses, older age, presence of sepsis, spontaneous bacterial peritonitis, pneumonia, urinary tract infection, acute renal failure, hepatic encephalopathy, and coagulopathy were independently associated with in-patient mortality. Conclusions: In-hospital mortality rate for AH remains high, especially in those with infectious complications, hepatic encephalopathy, coagulopathy, and acute renal failure. Our analysis documented significant healthcare cost and utilization among hospitalized AH patients.

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KW - in-hospital mortality

KW - NIS data

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