Alcohol-related cirrhosis worsened during pandemic, remains ‘top public health issue’
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CHICAGO — Hospital admissions for alcohol-related cirrhosis jumped from March 2020 to March 2021, with associated increases in costs and mortality, according to study results presented at Digestive Disease Week.
“The most striking finding from our study was the more than doubling in hospital admission for alcohol-related cirrhosis during the post-pandemic time period in both men and women,” Dina Halegoua-De Marzio, MD, associate professor of medicine and director of the Jefferson Fatty Liver Center at Thomas Jefferson University in Philadelphia, told Healio. “This was also associated with increased hospital costs and increased mortality rates. Costs increased in NASH cirrhosis patients, but we did not see increased admissions in this group.”
Using the Vizient clinical database, Halegoua-De Marzio and colleagues collected data from 809 U.S. hospitals from March 2019 to March 2021 to determine the impact of the COVID-19 pandemic in adult patients with alcohol-related and nonalcoholic steatohepatitis cirrhosis. They defined March 2019 to February 2020 as the pre-pandemic period and March 2020 to March 2021 as the post-pandemic period, and evaluated the number of hospital admissions, mean length of stay, percent deaths, 30-day readmission rate, mortality index and hospital cost during these times.
Researchers included 346,494 patients in the analysis, of whom 243,235 had alcoholic cirrhosis and 103,259 had NASH cirrhosis. Among the alcoholic cirrhosis cases, 75,363 were pre-pandemic and 167,872 were post-pandemic compared with 51,736 and 51,523, respectively, for NASH.
For women with alcoholic cirrhosis, researchers reported increases in mean length of stay (7.46 to 7.77), percent deaths (7.13% to 8.42%), mortality index (1.03 to 1.05) and mean direct cost ($13,899 to $15,066), although 30-day readmissions dropped from 22.43% to 22.08%. In men with alcoholic cirrhosis, researchers reported similar increases in mean length of stay (7.4 to 7.67), percent deaths (6.79% to 8.12%), mortality index (1 to 1.05) and mean direct cost ($14,058 to $15,081), with a decrease from 21.71% to 21.26% in 30-day readmission.
Among women with NASH cirrhosis, increases also were reported in length of stay (7.1 to 7.53), percent deaths (4.88% to 5.88%), mortality index (0.92 to 0.95) and mean direct cost increased ($14,938 to $16,381), while 30-day readmissions decreased from 20.03% to 19.6%. Men with NASH also had increases in mean length of stay (7.58 to 7.92), percent deaths (5.13 to 6.18), mortality index (0.90 to 0.95) and mean direct cost ($18,325 to $18,875). Thirty-day readmission decreased from 20.17% to 19.47%.
“This study emphasized that alcoholic liver disease remains a top public health issue, worsened with the COVID pandemic, and more patient education needs to be devoted to the potential danger of alcohol overuse,” Halegoua-De Marzio said.
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Schafer M, et al. Poster Su1514: COVID-19 impact on alcohol related cirrhosis and nonalcoholic steatohepatitis cirrhosis on hospital readmission and cost. Presented at: Digestive Disease Week; May 5-9, 2023; Chicago (hybrid meeting).
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