Retrospective Study
Copyright ©The Author(s) 2022.
World J Gastroenterol. Sep 14, 2022; 28(34): 5036-5046
Published online Sep 14, 2022. doi: 10.3748/wjg.v28.i34.5036
Table 1 Diagnosis to be included International Classification of Diseases-9 and its correspondent International Classification of Diseases-10
ICD-9
Correspondent ICD-10
571.0 alcoholic fatty liverK.70 alcoholic fatty liver
571.1 acute alcoholic hepatitisK.70.11 alcoholic hepatitis with ascites
K.70.10 alcoholic hepatitis without ascites
571.2 alcoholic cirrhosis of liverCorrespondent ICD-10 found
571.3 alcoholic liver damage, unspecifiedK70.40 alcoholic hepatic failure without coma
K70.41 alcoholic hepatic failure with coma
K70.9 alcoholic liver disease, unspecified
Table 2 Trend of alcoholic hepatitis-related hospitalization 2011 to 2017

2011
2012
2013
2014
2015
2016
2017
P
Total admission, n38590733364848463559779235358818357699423567542135798453
AH-related admission, n (%)281506 (0.7)274365 (0.8)278580 (0.8)291435 (0.8)308765 (0.9)313235 (0.9)324050 (0.9)< 0.001
Admission when primary admission diagnosis is AH, n (%)47140 (0.1)45710 (0.1)46715 (0.1)48395 (0.1)54955 (0.2)66170 (0.2)71290 (0.2)< 0.001
Table 3 Summary statistics of demographic of hospitalized alcoholic hepatitis patients, 2011 to 2017
Characteristic
AH-related admission
P1
2011
2012
2013
2014
2015
2016
2017
Overall
Between-group
n281506274365278580291435308765313235324050
Age in years at admission [median (Q1, Q3)]54.0 (46.0, 61.0)54.0 (46.0, 61.0)54.0 (46.0, 62.0)54.0 (46.0, 62.0)54.0 (46.0, 62.0)54.0 (46.0, 62.0)55.0 (46.0, 62.0)< 0.001
Age group (yr)< 0.001
< 25, n (%)1545 (0.5)1215 (0.4)1135 (0.4)1295 (0.4)1320 (0.4)1635 (0.5)1535 (0.5)0.011
25-44, n (%)57738 (20.5)57040 (20.8)58155 (20.9)61335 (21.0)66670 (21.6)69165 (22.1)70935 (21.9)< 0.001
45-64, n (%)170876 (60.7)166030 (60.5)167810 (60.2)174765 (60.0)181845 (58.9)182905 (58.4)187350 (57.8)< 0.001
≥65, n (%)51348 (18.2)50080 (18.3)51480 (18.5)54040 (18.5)58930 (19.1)59530 (19.0)64230 (19.8)< 0.001
Gender< 0.001
Male, n (%)198491 (70.5)195350 (71.2)196820 (70.7)203735 (69.9)216650 (70.2)218295 (69.7)227080 (70.1)< 0.001
Female, n (%)83016 (29.5)79000 (28.8)81725 (29.3)87615 (30.1)92075 (29.8)94810 (30.3)96965 (29.9)< 0.001
Missing, n (%)0 (0.0)15 (0.0)35 (0.0)85 (0.0)40 (0.0)130 (0.0)5 (0.0)
Race< 0.001
White, n (%)178031 (63.2)180550 (65.8)183125 (65.7)193560 (66.4)202205 (65.5)207155 (66.1)214760 (66.3)< 0.001
Black, n (%)27402.8 (9.7)27045 (9.9)26625 (9.6)27630 (9.5)29145 (9.4)28025 (8.9)29290 (9.0)< 0.001
Hispanic, n (%)37280 (13.2)36670 (13.4)38575 (13.8)38905 (13.3)43390 (14.1)45870 (14.6)49135 (15.2)< 0.001
Asian or Pacific Islander, n (%)2235 (0.8)2370 (0.9)2680 (1.0)2855 (1.0)3565 (1.2)3520 (1.1)3840 (1.2)< 0.001
Native American, n (%)5056 (1.8)5985 (2.2)5720 (2.1)5910 (2.0)6725 (2.2)7140 (2.3)7565 (2.3)< 0.001
Other, n (%)7134 (2.5)7760 (2.8)6940 (2.5)7785 (2.7)7780 (2.5)8305 (2.7)9085 (2.8)0.030
Missing, n (%)24368.5 (8.7)13985 (5.1)14915 (5.4)14790 (5.1)15955 (5.2)13220 (4.2)10375 (3.2)
Median household income national quartile for patient ZIP code< 0.001
$1-$38999, n (%)79993 (28.4)83510 (30.4)80530 (28.9)85525 (29.3)95660 (31.0)94940 (30.3)95785 (29.6)< 0.001
$39000-$47999, n (%)69137 (24.6)66095 (24.1)71125 (25.5)76895 (26.4)72860 (23.6)77800 (24.8)83130 (25.7)< 0.001
$48000-$62999, n (%)68313 (24.3)62360 (22.7)65010 (23.3)65695 (22.5)72025 (23.3)73690 (23.5)75805 (23.4)< 0.001
$63000 or more, n (%)56576 (20.1)53795 (19.6)53035 (19.0)54360 (18.7)59515 (19.3)58905 (18.8)60560 (18.7)< 0.001
Missing, n (%)7487.7 (2.7)8605 (3.1)8880 (3.2)8960 (3.1)8705 (2.8)7900 (2.5)8770 (2.7)
Primary expected payer < 0.001
Medicare, n (%)82774 (29.4)81905 (29.9)85335 (30.6)88860 (30.5)93460 (30.3)94160 (30.1)99510 (30.7)< 0.001
Medicaid, n (%)60601 (21.5)61975 (22.6)62490 (22.4)86040 (29.5)96230 (31.2)100255 (32.0)105305 (32.5)< 0.001
Private including HMO, n (%)71261 (25.3)65885 (24.0)65405 (23.5)70445 (24.2)76095 (24.6)75795 (24.2)76200 (23.5)< 0.001
Self-pay, n (%)45272 (16.1)43865 (16.0)42785 (15.4)31705 (10.9)28095 (9.1)27930 (8.9)28890 (8.9)< 0.001
No charge, n (%)4980.6 (1.8)3455 (1.3)5330 (1.9)3235 (1.1)3195 (1.0)2995 (1.0)2610 (0.8)< 0.001
Other, n (%)15296.9 (5.4)16515 (6.0)16670 (6.0)10555 (3.6)11150 (3.6)11625 (3.7)10805 (3.3)< 0.001
Missing, n (%)1320 (0.5)765 (0.3)565 (0.2)595 (0.2)540 (0.2)475 (0.2)730 (0.2)
Bed size of hospital < 0.001
Small, n (%)32567 (11.6)36820 (13.4)37640 (13.5)54105 (18.6)54870 (17.8)57875 (18.5)64035 (19.8)< 0.001
Medium, n (%)73628 (26.2)77055 (28.1)76680 (27.5)86355 (29.6)94260 (30.5)91795 (29.3)97445 (30.1)< 0.001
Large, n (%)175312 (62.3)160490 (58.5)164260 (59.0)150975 (51.8)159635 (51.7)163565 (52.2)162570 (50.2)< 0.001
Region of hospital0.001
Northeast, n (%)53252 (18.9)51120 (18.6)51855 (18.6)53795 (18.5)56100 (18.2)57590 (18.4)59600 (18.4)0.16
Midwest, n (%)61095 (21.7)59575 (21.7)60330 (21.7)64160 (22.0)67170 (21.8)68655 (21.9)72150 (22.3)0.42
South, n (%)95441 (33.9)94365 (34.4)95705 (34.4)98035 (33.6)105260 (34.1)105730 (33.8)108555 (33.5)0.017
West, n (%)71718 (25.5)69305 (25.3)70690 (25.4)75445 (25.9)80235 (26.0)81260 (25.9)83745 (25.8)0.046
Location teaching status of hospital< 0.001
Rural, n (%)28721 (10.2)27135 (9.9)26909.9 (9.7)23195 (8.0)23990 (7.8)24250 (7.7)25035 (7.7)< 0.001
Urban non-teaching, n (%)127976 (45.5)113625 (41.4)112610 (40.4)84150 (28.9)88965 (28.8)87650 (28.0)77930 (24.0)< 0.001
Urban teaching, n (%)124809 (44.3)133605 (48.7)139060 (49.9)184090 (63.2)195810 (63.4)201335 (64.3)221085 (68.2)< 0.001
Table 4 Mortality-related risk factors in alcoholic hepatitis patients who expired while hospitalized, 2011 to 2017

2011
2012
2013
2014
2015
2016
2017
P
n15002148451531015885163851743517785
Sepsis, n (%)1111 (7.4)950 (6.4)980 (6.4)1170 (7.4)2850 (17.4)8145 (46.7)8595 (48.3)< 0.001
GI hemorrhage, n (%)2582 (17.2)2755 (18.6)2715 (17.7)3230 (20.3)3025 (18.5)3355 (19.2)3395 (19.1)0.042
Acute renal failure, n (%)8941 (59.6)9450 (63.7)9780 (63.9)10485 (66.0)11265 (68.8)12325 (70.7)12825 (72.1)< 0.001
Table 5 Multivariable logistic regression on death during hospitalization among alcoholic hepatitis-related admission1 from 2011 to 2017
Variables
Levels
Odds ratio
Estimate
95% confidence interval
P after Bonferroni correction2
Age groups (yr)< 251.0Reference
25-441.891.28-2.790.039
45-642.851.93-4.21< 0.0001
65/65+3.552.4-5.25< 0.0001
SexMaleReference
Female1.131.09-1.17< 0.0001
RaceWhite1.0Reference
Black0.820.77-0.86< 0.0001
Hispanic0.940.9-0.980.20
Asian or Pacific Islander0.920.8-1.071.00
Native American1.040.94-1.151.00
Other1.121.02-1.220.36
Primary expected payerMedicare1.0Reference
Medicaid1.121.07-1.180.00020
Private including HMO1.111.06-1.170.00025
Self-pay1.371.29-1.45< 0.0001
No charge0.920.78-1.091.00
Other1.451.34-1.57< 0.0001
Median household income national quartile for patient ZIP code$1-$389991.0Reference
$39000-$479990.980.94-1.021.00
$48000-$629990.950.92-10.84
$63000 or more0.90.86-0.940.00021
Bed size of hospital Small1.0Reference
Medium1.21.14-1.26< 0.0001
Large1.31.25-1.37< 0.0001
Region of hospitalNortheast1.0Reference
Midwest0.910.87-0.960.0062
South10.96-1.051.00
West1.081.03-1.140.023
Location/teaching status of hospitalRural1.0Reference
Urban non-teaching1.030.97-1.11.00
Urban teaching1.081.02-1.150.28
SepsisYes3.333.2-3.47< 0.0001
GI hemorrhageYes2.312.22-2.4< 0.0001
Acute renal failureYes7.196.96-7.42< 0.0001