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Hepatitis C and hospital outcomes in patients admitted with alcohol-related problems
Judith I Tsui1, Mark J Pletcher, Eric Vittinghoff
1Division of General Medicine, General Internal Medicine Section (111A1), San Francisco Veteran Administration Medical Center, University of California, 4150 Clement Street, San Francisco, CA 94121, USA. judith.tsui@med.va.gov
Insights
Hospitalized patients with alcohol abuse and hepatitis C virus (HCV) infection face higher mortality risks and longer hospital stays. This study highlights the critical impact of co-infection on patient outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Alcohol abuse and chronic hepatitis C virus (HCV) infection are known contributors to liver disease.
- The combined impact on acutely hospitalized patients with alcohol problems requires further investigation.
Purpose of the Study:
- To determine the effect of HCV infection on hospital mortality.
- To assess the impact of HCV infection on length of hospital stay in patients with alcohol abuse.
Main Methods:
- Retrospective analysis of 6354 hospital admissions for alcohol dependence or abuse.
- Extraction of hepatitis C diagnosis and other data from a clinical database.
- Multivariable regression analysis to test associations with death and length of hospital stay.
Main Results:
- 15% of patients with alcohol abuse had a diagnosed HCV infection.
- HCV-infected patients were twice as likely to die during admission (4.4% vs. 2.4%, P<0.01).
- Patients with HCV had significantly longer hospital stays (19% longer).
Conclusions:
- Hospitalized patients with alcohol-related diagnoses and HCV infection experience increased mortality.
- HCV co-infection is associated with prolonged hospital stays in patients with alcohol abuse.
Background/Aims:
Alcohol is known to act synergistically with chronic hepatitis C virus (HCV) infection to cause liver disease; however, their combined effect on outcomes in acutely hospitalized patients is less clear. We examined the impact of HCV infection on hospital mortality and length of stay among hospitalized patients with alcohol abuse problems.
Methods:
We retrospectively identified 6354 admissions to an urban, public hospital between July 1996 and January 2002 with discharge diagnoses related to alcohol dependence or abuse. Hepatitis C diagnosis and other information were extracted from a clinical database and tested for associations with death and length of hospital stay using multivariable regression techniques.
Results:
The prevalence of diagnosed HCV infection in this sample of patients with alcohol abuse was 15%. Patients with HCV were about twice as likely to die during hospital admission (4.4 vs. 2.4%; P-value < 0.01), and there appeared to be a trend toward increased mortality even after adjustment for demographics, medical service, homelessness and comorbidities (fully adjusted OR 1.41; 95% CI: 0.97-2.04). Length of stay was significantly longer for patients with HCV (19% longer; 95% CI: 12-27% after adjustment) than those without.
Conclusions:
Patients admitted to the hospital with alcohol-related diagnoses have longer hospital stays and are more likely to die in hospital if they have a diagnosis of HCV.
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