Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2017; 23(40): 7274-7282
Published online Oct 28, 2017. doi: 10.3748/wjg.v23.i40.7274
Clinical features of alcoholic hepatitis in latinos and caucasians: A single center experience
Rogelio Pinon-Gutierrez, Blythe Durbin-Johnson, Charles H Halsted, Valentina Medici
Rogelio Pinon-Gutierrez, Charles H Halsted, Valentina Medici, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California Davis, Sacramento, CA 95817, United States
Blythe Durbin-Johnson, Division of Biostatistics University of California Davis, Department of Public Health Sciences, Davis, CA 95616, United States
Author contributions: Pinon-Gutierrez R and Halsted CH helped design the research project; Pinon-Gutierrez R contributed to perform data acquisition and drafted the manuscript; Durbin-Johnson B performed statistical analysis; Durbin-Johnson B, Halsted CH and Medici V contributed to manuscript preparation; Medici V conducted the study design and supervised the data collection.
Supported by the project described was supported by the National Center for Advancing Translational Sciences, through grant number UL1 TR001860. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Institutional review board statement: The study was reviewed and approved by the University of California of Davis Institutional Review Board.
Informed consent statement: No informed consent from subjects was required for this retrospective study.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Valentina Medici, MD, Associate Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California Davis, 150 V Street, PSSB suite 3500, Sacramento, CA 95817, United States. vmedici@ucdavis.edu
Telephone: +1-916-7343751 Fax: +1-916-7347908
Received: August 16, 2017
Peer-review started: August 17, 2017
First decision: August 30, 2017
Revised: September 19, 2017
Accepted: September 26, 2017
Article in press: September 26, 2017
Published online: October 28, 2017
Processing time: 74 Days and 3.5 Hours
Abstract
AIM

To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians.

METHODS

We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3.0 or coagulopathy, new onset of liver decompensation or acute liver decompensation in known cirrhosis within 12 wk of last drink.

RESULTS

The mean age at presentation of alcoholic hepatitis was not significantly different between Latinos and Caucasians. There was significant lower rate of overall substance abuse in Caucasians compared to Latinos and Latinos had a higher rate of methamphetamine abuse (12.5% vs 0.7%) compared to Caucasians. Latinos had a higher mean number of hospitalizations (5.3 ± 5.6 vs 2.7 ± 2.7, P = 0.001) and mean Emergency Department visits (9.5 ± 10.8 vs 4.5 ± 4.1, P = 0.017) for alcohol related issues and complications compared to Caucasians. There was significantly higher rate of complications of portal hypertension including gastrointestinal bleeding (79.7% vs 45.3%, P < 0.001), spontaneous bacterial peritonitis (26.6% vs 9.5%, P = 0.003), and encephalopathy (81.2% vs 55.5%, P = 0.001) in Latinos compared to Caucasians.

CONCLUSION

Latinos have significant higher rates of utilization of acute care services for manifestations alcoholic hepatitis and complications suggesting poor access to outpatient care.

Keywords: Alcoholic hepatitis; Latino; Hispanic; Caucasian; Alcoholic liver disease

Core tip: We conducted a retrospective chart review on Caucasian and Latino patients with alcoholic hepatitis. We showed that Latinos had significantly higher rates of gastrointestinal bleeding, encephalopathy, spontaneous bacterial peritonitis, recurrence of alcoholic hepatitis, and utilization of acute care services for alcohol related issues compared to Caucasians. However, the survival rates were not significantly different between Latinos and Caucasians. Our findings suggest that Latino patients have poor access to outpatient care and management of complications of portal hypertension.