Hepatitis C as a prognostic indicator among noncirrhotic patients hospitalized with alcoholic hepatitis
Insights
Hepatitis C virus (HCV) infection significantly increases in-hospital mortality for alcoholic hepatitis (AH) patients. This co-infection also leads to longer hospital stays and higher healthcare costs for noncirrhotic AH admissions.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Alcoholic hepatitis (AH) is a significant cause of liver disease-related mortality.
- The impact of co-existing hepatitis C virus (HCV) infection on AH outcomes is not fully understood.
- Understanding these interactions is crucial for patient management and resource allocation.
Purpose of the Study:
- To analyze the effect of HCV infection on short-term survival in patients admitted with AH.
- To assess the impact of HCV co-infection on hospital resource utilization among AH patients.
- To provide data on the combined burden of AH and HCV.
Main Methods:
- Nationwide Inpatient Sample database analysis (1998-2006).
- Identification of noncirrhotic patients admitted with AH using ICD-9 codes.
- Comparison of in-hospital mortality rates and hospital resource utilization (length of stay, charges) between AH patients with and without HCV.
Main Results:
- Over 112,000 AH admissions were analyzed.
- In-hospital mortality was substantially higher in AH patients with HCV (41.1% vs. 3.2%).
- HCV co-infection was associated with increased odds of mortality (aOR 1.48), longer hospital stays, and greater hospital charges.
Conclusions:
- HCV infection is linked to worse short-term outcomes in noncirrhotic AH patients.
- Co-infected patients require more hospital resources, including longer stays and higher costs.
- These findings highlight the importance of considering HCV status in AH management.
Objective:
A nationwide analysis of alcoholic hepatitis (AH) admissions was conducted to determine the impact of hepatitis C virus (HCV) infection on short-term survival and hospital resource utilization.
Methods:
Using the Nationwide Inpatient Sample, noncirrhotic patients admitted with AH throughout the United States between 1998 and 2006 were identified with diagnostic codes from the International Classification of Diseases, Ninth Revision. The in-hospital mortality rate (primary end point) of AH patients with and without co-existent HCV infection was determined. Hospital resource utilization was assessed as a secondary end point through linear regression analysis.
Results:
From 1998 to 2006, there were 112,351 admissions for AH. In-hospital mortality was higher among patients with coexistent HCV infection (41.1% versus 3.2%; P=0.07). The adjusted odds of in-hospital mortality in the presence of HCV was 1.48 (95% CI 1.10 to 1.98). Noncirrhotic patients with AH and HCV also had longer length of stay (5.8 days versus 5.3 days; P<0.007) as well as greater hospital charges (US$25,990 versus US$21,030; P=0.0002).
Conclusions:
Among noncirrhotic patients admitted with AH, HCV infection was associated with higher in-hospital mortality and resource utilization.
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