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Early rehabilitation reduces alcohol-related hepatitis readmission, mortality

Early alcohol rehabilitation reduced 30-day readmission, alcohol relapse and mortality among patients hospitalized for alcohol-related hepatitis, according to data published in Clinical Gastroenterology and Hepatology.

“In patients surviving an [alcohol-related hepatitis] admission, preventing alcohol relapse is crucial because long-term survival is dependent on abstinence rather than severity of liver disease,” Thoetchai B. Peeraphatdit, MD, from the Mayo Clinic College of Medicine in Minnesota, and colleagues wrote. “Thus, it is important to prevent alcohol relapse after hospital discharge to ensure long-term alcohol abstinence.”

The researchers reviewed alcohol rehabilitation data on 135 patients enrolled in a test cohort and 119 patients in a validation cohort. Twenty-seven patients from the test cohort and 19 from the validation cohort attended alcohol rehabilitation. Types of alcohol rehabilitation included residential, outpatient, and mutual support groups such as alcohol anonymous.

While not significant in the test cohort after multivariate analysis, having a college degree or higher in the validation cohort was an independent predictor of attending alcohol rehabilitation (adjusted OR = 4.62; 95% CI, 1.19-17.9).

The 30-day readmission rate was 30.4% in the test cohort and 30.8% in the validation cohort. Readmission rates were lower in those who attended early alcohol rehabilitation compared with those who did not in both the test (11% vs. 35.2%; P = .02) and validation cohorts (21.1% vs. 45%; P = .07).

The 30-day alcohol relapse rates were also lower in those who attended early alcohol rehabilitation compared with those who did not in both the test (7.4% vs. 44.4%; P < .001) and validation cohorts (5.3% vs. 45.9%; P < .001).

The mortality rates were 39.3% in the test cohort during a median of 2.8 years and 26.4% in the validation cohort during a median of 1.3 years. Multivariate analysis showed that attendance to early alcohol rehabilitation was an independent protective factor (adjusted HR = 0.2; 95% CI, 0.05-0.56).

“The 30-day readmission and 30-day alcohol relapse rates are 30% and 37%, respectively, after an [alcohol-related hepatitis] admission,” the researchers concluded. “Early alcohol rehabilitation is associated with reduction in hospital readmission, alcohol relapse, and death and should be pursued in all AH patients during and/or immediately following their hospitalization.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.