IMPACT OF THE COVID-19 PANDEMIC ON RATES OF ALCOHOL-RELATED HEPATITIS ADMISSIONS IN A MULTI-HOSPITAL US HEALTH SYSTEM

Document Type

Conference Proceeding

Publication Date

10-1-2022

Publication Title

Hepatology

Keywords

alcohol, adult, adverse drug reaction, alcoholic hepatitis, analysis of variance, conference abstract, controlled study, coronavirus disease 2019, demographics, dialysis, emergency care, female, hepatitis, hospital admission, human, ICD-10, liver graft, major clinical study, male, medical record review, Michigan, Model For End Stage Liver Disease Score, multicenter study, pandemic, race, retrospective study, side effect, surgery

Abstract

Background: Alcohol consumption significantly increased during the Covid-19 pandemic. We previously reported a 50% increase in the proportion of alcoholic hepatitis (AH)-related hospital admissions during May-Sept 2020 compared to the same period in 2016-2019. We investigated admission patterns in 2021 to determine the impact of the ongoing pandemic on the rate of AH admissions in a large health system in metropolitan Detroit, Michigan, an area that experienced a severe early surge in Covid cases. Methods: We conducted a retrospective analysis using data from an integrated health system with four acute care hospitals. Patients were identified based on ICD-10 codes, supplemented with chart review, for the periods of May-Sept in the eras: 2016-2019 (pre-Covid); 2020 (early pandemic); and 2021 (late pandemic). Demographic data, MELD score, and liver-related outcomes were investigated. Chi-square tests were used to compare rates of AH admissions (as a proportion of total admissions). Characteristics of AH patients were compared across eras using ANOVA for numeric variables and Chi-square tests for categorical variables. Multivariate logistic regression was used to identify factors associated with liver-related outcomes. Results: A total of 402 patients were admitted for alcoholic hepatitis during the 3 eras. The rate of AHR admissions was significantly higher in 2020 (0.31%) compared to 2016-2019 (0.21%, p=.001) and 2021 (0.13%, p<.001). However, the rate of AH admissions in 2021 was significantly lower than in 2016-2019 (p=.001). Baseline characteristics of AH patients were similar across time, except for race; a larger proportion of Black patients were admitted in 2020 (p=.011) and 2021 (p=.036) compared with 2016-2019. Era was associated with initiation of liver transplant evaluation for AH (significantly higher in 2021 than other eras, p<.001 for both) but was not associated with ICU admission, initiation of dialysis, or death. Higher MELD score at admission was associated with higher risk of ICU admission (p<.001), dialysis (p<.001), and death (p=.004) in all eras. Black patients were less likely to initiate transplant evaluation compared to those of other races (p=.034). Conclusion: Hospital admissions for alcoholic hepatitis were higher during the height of 2020 Covid-era restrictions compared with similar pre-pandemic and later pandemic periods. (Figure Presented).

Volume

76

First Page

S975

Last Page

S976

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