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Relative effects of heavy alcohol use and Hepatitis C in decompensated chronic liver disease in a hospital inpatient population
Abstract Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD)....
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| Published in: | The American journal of drug and alcohol abuse 2015-03, Vol.41 (2), p.177-182 |
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| container_title | The American journal of drug and alcohol abuse |
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| creator | Mankal, Pavan Kumar Abed, Jean Aristy, Jose David Munot, Khushboo Suneja, Upma Engelson, Ellen S. Kotler, Donald P. |
| description | Abstract
Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD). Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes. A thorough chart review captured information on demographics, viral hepatitis status, alcohol use and progression of liver disease (i.e. decompensation). Decompensation was defined as the presence of ascites due to portal hypertension, bleeding esophageal varices, hepatic encephalopathy or hepatorenal syndrome. Heavy alcohol use was defined as a chart entry of greater than six daily units of alcohol or its equivalent. Results: 347 patients were included based on our selection criteria of documented heavy alcohol use (n = 215; 62.0%), hepatitis titers (HCV: n = 182; 52.5%) and radiological evidence of CLD with or without decompensation (decompensation: n = 225; 64.8%). Independent of HCV infection, heavy alcohol use significantly increased the risk of decompensation (OR = 1.75, 95% CI 1.11-2.75, p |
| doi_str_mv | 10.3109/00952990.2014.964358 |
| format | article |
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Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD). Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes. A thorough chart review captured information on demographics, viral hepatitis status, alcohol use and progression of liver disease (i.e. decompensation). Decompensation was defined as the presence of ascites due to portal hypertension, bleeding esophageal varices, hepatic encephalopathy or hepatorenal syndrome. Heavy alcohol use was defined as a chart entry of greater than six daily units of alcohol or its equivalent. Results: 347 patients were included based on our selection criteria of documented heavy alcohol use (n = 215; 62.0%), hepatitis titers (HCV: n = 182; 52.5%) and radiological evidence of CLD with or without decompensation (decompensation: n = 225; 64.8%). Independent of HCV infection, heavy alcohol use significantly increased the risk of decompensation (OR = 1.75, 95% CI 1.11-2.75, p < 0.02) relative to no heavy alcohol use. No significance was seen with age, sex, race, HIV, viral hepatitis and moderate alcohol use for risk for decompensation. Additionally, dose-relationship regression analysis revealed that heavy, but not moderate alcohol use, resulted in a three-fold increase (p = 0.013) in the risk of decompensation relative to abstinence. Conclusions: While both heavy alcohol use and HCV infection are associated with risk of developing CLD, our data suggest that heavy, but not moderate, alcohol consumption is associated with a greater risk for hepatic decompensation in patients with cirrhosis than does HCV infection.</description><identifier>ISSN: 0095-2990</identifier><identifier>EISSN: 1097-9891</identifier><identifier>DOI: 10.3109/00952990.2014.964358</identifier><identifier>PMID: 25320839</identifier><identifier>CODEN: AJDABD</identifier><language>eng</language><publisher>England: Informa Healthcare USA, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Alcohol ; Alcohol Abuse ; Alcohol use ; Alcoholism - complications ; Alcoholism - pathology ; ascites ; Blood Diseases ; Blood Pressure ; cirrhosis ; Cross-Sectional Studies ; Disease Progression ; Diseases ; Drinking Behavior ; end stage liver disease ; Female ; Graphs ; Hepatic Encephalopathy - complications ; Hepatic Encephalopathy - pathology ; Hepatitis ; Hepatitis C ; Hepatitis C - complications ; Hepatitis C - pathology ; Hospitals ; Humans ; Inpatient care ; Inpatients ; Liver cirrhosis ; Liver diseases ; Liver Failure - complications ; Liver Failure - pathology ; Male ; Middle Aged ; Patients ; Retrospective Studies ; Risk ; varices</subject><ispartof>The American journal of drug and alcohol abuse, 2015-03, Vol.41 (2), p.177-182</ispartof><rights>2015 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted 2015</rights><rights>Copyright Marcel Dekker, Inc. Mar 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-b36d647105012baa3c81aa7c61127bfd65487c1281c0bd630815f19fee1a03833</citedby><cites>FETCH-LOGICAL-c479t-b36d647105012baa3c81aa7c61127bfd65487c1281c0bd630815f19fee1a03833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,30999,33774,33775</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25320839$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mankal, Pavan Kumar</creatorcontrib><creatorcontrib>Abed, Jean</creatorcontrib><creatorcontrib>Aristy, Jose David</creatorcontrib><creatorcontrib>Munot, Khushboo</creatorcontrib><creatorcontrib>Suneja, Upma</creatorcontrib><creatorcontrib>Engelson, Ellen S.</creatorcontrib><creatorcontrib>Kotler, Donald P.</creatorcontrib><title>Relative effects of heavy alcohol use and Hepatitis C in decompensated chronic liver disease in a hospital inpatient population</title><title>The American journal of drug and alcohol abuse</title><addtitle>Am J Drug Alcohol Abuse</addtitle><description>Abstract
Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD). Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes. A thorough chart review captured information on demographics, viral hepatitis status, alcohol use and progression of liver disease (i.e. decompensation). Decompensation was defined as the presence of ascites due to portal hypertension, bleeding esophageal varices, hepatic encephalopathy or hepatorenal syndrome. Heavy alcohol use was defined as a chart entry of greater than six daily units of alcohol or its equivalent. Results: 347 patients were included based on our selection criteria of documented heavy alcohol use (n = 215; 62.0%), hepatitis titers (HCV: n = 182; 52.5%) and radiological evidence of CLD with or without decompensation (decompensation: n = 225; 64.8%). Independent of HCV infection, heavy alcohol use significantly increased the risk of decompensation (OR = 1.75, 95% CI 1.11-2.75, p < 0.02) relative to no heavy alcohol use. No significance was seen with age, sex, race, HIV, viral hepatitis and moderate alcohol use for risk for decompensation. Additionally, dose-relationship regression analysis revealed that heavy, but not moderate alcohol use, resulted in a three-fold increase (p = 0.013) in the risk of decompensation relative to abstinence. Conclusions: While both heavy alcohol use and HCV infection are associated with risk of developing CLD, our data suggest that heavy, but not moderate, alcohol consumption is associated with a greater risk for hepatic decompensation in patients with cirrhosis than does HCV infection.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alcohol</subject><subject>Alcohol Abuse</subject><subject>Alcohol use</subject><subject>Alcoholism - complications</subject><subject>Alcoholism - pathology</subject><subject>ascites</subject><subject>Blood Diseases</subject><subject>Blood Pressure</subject><subject>cirrhosis</subject><subject>Cross-Sectional Studies</subject><subject>Disease Progression</subject><subject>Diseases</subject><subject>Drinking Behavior</subject><subject>end stage liver disease</subject><subject>Female</subject><subject>Graphs</subject><subject>Hepatic Encephalopathy - complications</subject><subject>Hepatic Encephalopathy - pathology</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C - complications</subject><subject>Hepatitis C - pathology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Inpatients</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Liver Failure - complications</subject><subject>Liver Failure - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>varices</subject><issn>0095-2990</issn><issn>1097-9891</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkU2L1TAUhoMoznX0H4gE3LjpNR9tk2wUuYyOMCCIrkuantAMaVKTduSu_OuTcmdEXYyrEPK8z-HkReglJXtOiXpLiGqYUmTPCK33qq15Ix-hXXkSlZKKPka7Dak25gw9y_maEEKlqJ-iM9ZwRiRXO_TrK3i9uBvAYC2YJeNo8Qj65oi1N3GMHq8ZsA4DvoS5kIvL-IBdwAOYOM0Qsl5gwGZMMTiDfVElPLgMusQKpvEY8-wW7cttE0BY8BzndRsbw3P0xGqf4cXdeY6-f7z4drisrr58-nz4cFWZWqil6nk7tLWgpCGU9VpzI6nWwrSUMtHboW1qKQxlkhrSDy0nkjaWKgtANeGS83P05uSdU_yxQl66yWUD3usAcc0dFUy2jeTlZ_6Lto3gTCgiCvr6H_Q6rimURTZK1kxQpQpVnyiTYs4JbDcnN-l07Cjpti67-y67rcvu1GWJvbqTr_0Ew-_QfXkFeH8CXLAxTfpnTH7oFn30Mdmkg3F50z844t1fhlK8X0ajE_yxyEOCWx6hwPU</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Mankal, Pavan Kumar</creator><creator>Abed, Jean</creator><creator>Aristy, Jose David</creator><creator>Munot, Khushboo</creator><creator>Suneja, Upma</creator><creator>Engelson, Ellen S.</creator><creator>Kotler, Donald P.</creator><general>Informa Healthcare USA, Inc</general><general>Informa Healthcare</general><general>Taylor & Francis Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7U3</scope><scope>BHHNA</scope><scope>K7.</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>Relative effects of heavy alcohol use and Hepatitis C in decompensated chronic liver disease in a hospital inpatient population</title><author>Mankal, Pavan Kumar ; Abed, Jean ; Aristy, Jose David ; Munot, Khushboo ; Suneja, Upma ; Engelson, Ellen S. ; Kotler, Donald P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-b36d647105012baa3c81aa7c61127bfd65487c1281c0bd630815f19fee1a03833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alcohol</topic><topic>Alcohol Abuse</topic><topic>Alcohol use</topic><topic>Alcoholism - complications</topic><topic>Alcoholism - pathology</topic><topic>ascites</topic><topic>Blood Diseases</topic><topic>Blood Pressure</topic><topic>cirrhosis</topic><topic>Cross-Sectional Studies</topic><topic>Disease Progression</topic><topic>Diseases</topic><topic>Drinking Behavior</topic><topic>end stage liver disease</topic><topic>Female</topic><topic>Graphs</topic><topic>Hepatic Encephalopathy - complications</topic><topic>Hepatic Encephalopathy - pathology</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C - complications</topic><topic>Hepatitis C - pathology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inpatient care</topic><topic>Inpatients</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Liver Failure - complications</topic><topic>Liver Failure - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>varices</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mankal, Pavan Kumar</creatorcontrib><creatorcontrib>Abed, Jean</creatorcontrib><creatorcontrib>Aristy, Jose David</creatorcontrib><creatorcontrib>Munot, Khushboo</creatorcontrib><creatorcontrib>Suneja, Upma</creatorcontrib><creatorcontrib>Engelson, Ellen S.</creatorcontrib><creatorcontrib>Kotler, Donald P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of drug and alcohol abuse</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mankal, Pavan Kumar</au><au>Abed, Jean</au><au>Aristy, Jose David</au><au>Munot, Khushboo</au><au>Suneja, Upma</au><au>Engelson, Ellen S.</au><au>Kotler, Donald P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relative effects of heavy alcohol use and Hepatitis C in decompensated chronic liver disease in a hospital inpatient population</atitle><jtitle>The American journal of drug and alcohol abuse</jtitle><addtitle>Am J Drug Alcohol Abuse</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>41</volume><issue>2</issue><spage>177</spage><epage>182</epage><pages>177-182</pages><issn>0095-2990</issn><eissn>1097-9891</eissn><coden>AJDABD</coden><abstract>Abstract
Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD). Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes. A thorough chart review captured information on demographics, viral hepatitis status, alcohol use and progression of liver disease (i.e. decompensation). Decompensation was defined as the presence of ascites due to portal hypertension, bleeding esophageal varices, hepatic encephalopathy or hepatorenal syndrome. Heavy alcohol use was defined as a chart entry of greater than six daily units of alcohol or its equivalent. Results: 347 patients were included based on our selection criteria of documented heavy alcohol use (n = 215; 62.0%), hepatitis titers (HCV: n = 182; 52.5%) and radiological evidence of CLD with or without decompensation (decompensation: n = 225; 64.8%). Independent of HCV infection, heavy alcohol use significantly increased the risk of decompensation (OR = 1.75, 95% CI 1.11-2.75, p < 0.02) relative to no heavy alcohol use. No significance was seen with age, sex, race, HIV, viral hepatitis and moderate alcohol use for risk for decompensation. Additionally, dose-relationship regression analysis revealed that heavy, but not moderate alcohol use, resulted in a three-fold increase (p = 0.013) in the risk of decompensation relative to abstinence. Conclusions: While both heavy alcohol use and HCV infection are associated with risk of developing CLD, our data suggest that heavy, but not moderate, alcohol consumption is associated with a greater risk for hepatic decompensation in patients with cirrhosis than does HCV infection.</abstract><cop>England</cop><pub>Informa Healthcare USA, Inc</pub><pmid>25320839</pmid><doi>10.3109/00952990.2014.964358</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Alcohol Alcohol Abuse Alcohol use Alcoholism - complications Alcoholism - pathology ascites Blood Diseases Blood Pressure cirrhosis Cross-Sectional Studies Disease Progression Diseases Drinking Behavior end stage liver disease Female Graphs Hepatic Encephalopathy - complications Hepatic Encephalopathy - pathology Hepatitis Hepatitis C Hepatitis C - complications Hepatitis C - pathology Hospitals Humans Inpatient care Inpatients Liver cirrhosis Liver diseases Liver Failure - complications Liver Failure - pathology Male Middle Aged Patients Retrospective Studies Risk varices |
| title | Relative effects of heavy alcohol use and Hepatitis C in decompensated chronic liver disease in a hospital inpatient population |
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