Disparities in Alcohol-Associated Liver Disease Hospital Encounters Amongst a Texas-Based Cohort of Patients

被引:0
作者
Cotter, Thomas G. [1 ]
Anouti, Ahmad [1 ]
Zhang, Bill [2 ]
Rady, Elias D. [1 ]
Patel, Mausam [2 ]
Patel, Suraj [1 ]
Ellis, Daniel J. [1 ]
Lieber, Sarah R. [1 ]
Rich, Nicole E. [1 ]
O'Leary, Jacqueline G. [1 ]
Mitchell, Mack C. [1 ]
Singal, Amit G. [1 ]
机构
[1] UT Southwestern Med Ctr, Div Digest & Liver Dis, Dallas, TX 75390 USA
[2] UT Southwestern Med Ctr, Dept Internal Med, Dallas, TX USA
关键词
alcohol use disorder; alcohol-associated hepatitis; alcohol-associated liver disease; disparities; MORTALITY; PREVALENCE; GENDER;
D O I
10.1111/apt.18477
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction: Alcohol-associated liver disease (ALD) disproportionately impacts men, racial and ethnic minorities, and individuals of low socioeconomic status; however, it's unclear how recent increases in ALD burden have impacted these disparities. We aimed to describe trends in racial, ethnic and socioeconomic disparities in alcohol-associated hospital encounters. Methods: We conducted a retrospective cohort study of adult hospital encounters with alcohol-associated diagnoses from three health systems between January 2016 and December 2021. The cohort was divided into three eras: a 'Historical Era,' (Oct 2016-June 2018, used only for trends); 'Era 1' (July 2018-March 2020); and 'Era 2' (April 2020-December 2021). Kaplan Meier and Cox regression analyses were performed to identify factors associated with overall survival. Results: We identified 19,295 individuals with alcohol-associated encounters (44.7% White, 29.8% Hispanic, and 21.8% non-Hispanic Black (NHB) individuals), with a greater increase observed between eras 1 and 2 than the historical era and Era 1 (8.7% vs. 5.0%, p < 0.01). By age and sex, the greatest increases in encounters were observed in the youngest and oldest females but only the oldest males. By race and ethnicity, Hispanic individuals had greater increases in encounters compared to Black and White individuals (14.8% vs. 7.5% and 6.3%, p < 0.01). Older age (aSHR: 1.03, 95% CI: 1.03-1.0), higher MELD (aSHR: 1.08, 95% CI: 1.0-1.09), hepatic encephalopathy (aSHR: 1.42, 95% CI: 1.06-1.90), and hepatocellular carcinoma (HCC) (aSHR: 3.20, 95% CI: 2.29-4.49) were associated with increased mortality. Conclusion: The highest increases of alcohol-associated encounters were observed amongst young Hispanic and NHB women, highlighting variation in trends by age, sex, race and ethnicity. These disparities merit further investigation to elucidate underlying mechanisms and develop tailored interventions to improve ALD burden and outcomes.
引用
收藏
页码:988 / 999
页数:12
相关论文
共 48 条
  • [31] The impact of the COVID lockdown on alcohol consumption in the Netherlands. The role of living arrangements and social isolation
    Mangot-Sala, Lluis
    Tran, Khoa A.
    Smidt, Nynke
    Liefbroer, Aart C.
    [J]. DRUG AND ALCOHOL DEPENDENCE, 2022, 233
  • [32] Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis (AH): individual data analysis of the last three randomized placebo controlled double blind trials of corticosteroids in severe AH
    Mathurin, P
    Mendenhall, CL
    Carithers, RL
    Ramond, MJ
    Maddrey, WC
    Garstide, P
    Rueff, B
    Naveau, S
    Chaput, JC
    Poynard, T
    [J]. JOURNAL OF HEPATOLOGY, 2002, 36 (04) : 480 - 487
  • [33] The impact of COVID-19 on alcohol sales and consumption in the United States: A retrospective, observational analysis
    Moskatel, Leon S.
    Slusky, David J. G.
    [J]. ALCOHOL, 2023, 111 : 25 - 31
  • [34] Inequitable access to general and behavioral healthcare in the US during the COVID-19 pandemic: A role for telehealth?
    Mulia, Nina
    Ye, Yu
    Greenfield, Thomas K.
    Martinez, Priscilla
    Patterson, Deidre
    Kerr, William C.
    Karriker-Jaffe, Katherine J.
    [J]. PREVENTIVE MEDICINE, 2023, 169
  • [35] Racial disparity in liver disease: Biological, cultural, or socioeconomic factors
    Nguyen, Geoffrey C.
    Thuluvath, Paul J.
    [J]. HEPATOLOGY, 2008, 47 (03) : 1058 - 1066
  • [36] Changes in drinking days among United States adults during the COVID-19 pandemic
    Nordeck, Courtney D.
    Riehm, Kira E.
    Smail, Emily J.
    Holingue, Calliope
    Kane, Jeremy C.
    Johnson, Renee M.
    Veldhuis, Cindy B.
    Kalb, Luther G.
    Stuart, Elizabeth A.
    Kreuter, Frauke
    Thrul, Johannes
    [J]. ADDICTION, 2022, 117 (02) : 331 - 340
  • [37] Racial disparities in nonalcoholic fatty liver disease clinical trial enrollment: A systematic review and meta-analysis
    Patel, Parita
    Muller, Charles
    Paul, Sonali
    [J]. WORLD JOURNAL OF HEPATOLOGY, 2020, 12 (08) : 506 - 518
  • [38] Alcohol consumption and alcohol-related problems during the COVID-19 pandemic: a narrative review
    Ramalho, Rodrigo
    [J]. AUSTRALASIAN PSYCHIATRY, 2020, 28 (05) : 524 - 526
  • [39] Race and Ethnicity in Non-Alcoholic Fatty Liver Disease (NAFLD): A Narrative Review
    Riazi, Kiarash
    Swain, Mark G.
    Congly, Stephen E.
    Kaplan, Gilaad G.
    Shaheen, Abdel-Aziz
    [J]. NUTRIENTS, 2022, 14 (21)
  • [40] Alcohol Consumption and Risk of Liver Cirrhosis: A Systematic Review and Meta-Analysis
    Roerecke, Michael
    Vafaei, Afshin
    Hasan, Omer S. M.
    Chrystoja, Bethany R.
    Cruz, Marcus
    Lee, Roy
    Neuman, Manuela G.
    Rehm, Jurgen
    [J]. AMERICAN JOURNAL OF GASTROENTEROLOGY, 2019, 114 (10) : 1574 - 1586