Department of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
Department of Gastroenterology and Hepatology, Marshall University Hospital, Huntington, WV 25701, USA.
World J Gastroenterol. 2022 Sep 14;28(34):5036-5046. doi: 10.3748/wjg.v28.i34.5036.
Severe alcoholic hepatitis (AH) is one of the most lethal manifestations of alcohol-associated liver disease. In light of the increase in alcohol consumption worldwide, the incidence of AH is on the rise, and data examining the trends of AH admission is needed.
To examine inpatient admission trends secondary to AH, along with their clinical outcomes and epidemiological characteristics.
The National Inpatient Sample (NIS) database was utilized, and data from 2011 to 2017 were reviewed. We included individuals aged ≥ 21 years who were admitted with a primary or secondary diagnosis of AH using the International Classification of Diseases (ICD)-9 and its correspondent ICD-10 codes. Hepatitis not related to alcohol was excluded. The national estimates of inpatient admissions were obtained using sample weights provided by the NIS.
AH-related hospitalization demonstrated a significant increase in the USA from 281506 (0.7% of the total admission in 2011) to 324050 (0.9% of the total admission in 2017). The median age was 54 years. The most common age group was 45-65 years (range 57.8%-60.7%). The most common race was white (63.2%-66.4%), and patients were predominantly male (69.7%-71.2%). The primary healthcare payers were Medicare (29.4%-30.7%) and Medicaid (21.5%-32.5%). The most common geographical location was the Southern USA (33.6%-34.4%). Most patients were admitted to a tertiary care center (50.2%-62.3%) located in urban areas. Mortality of AH in this inpatient sample was 5.3% in 2011 and 5.5% in 2017. The most common mortality-associated risk factors were acute renal failure (59.6%-72.1%) and gastrointestinal hemorrhage (17.2%-20.3%). The total charges were noted to range between $25242.62 and $34874.50.
The number of AH inpatient hospitalizations significantly increased from 2011 to 2017. This could have a substantial financial impact with increasing healthcare costs and utilization. AH-mortality remained the same.
重症酒精性肝炎（AH）是与酒精相关的肝病中最致命的表现之一。鉴于全球酒精消费的增加，AH 的发病率呈上升趋势，因此需要研究 AH 入院的趋势数据。
研究 AH 住院的趋势，以及它们的临床结果和流行病学特征。
利用国家住院患者样本（NIS）数据库，回顾了 2011 年至 2017 年的数据。我们纳入了年龄≥21 岁的患者，这些患者使用国际疾病分类（ICD）-9 及其对应的 ICD-10 代码被诊断为原发性或继发性 AH。排除了与酒精无关的肝炎。通过 NIS 提供的样本权重获得全国住院人数的估计值。
美国 AH 相关住院治疗的人数显著增加，从 2011 年的 281506 例（占总入院人数的 0.7%）增加到 2017 年的 324050 例（占总入院人数的 0.9%）。中位年龄为 54 岁。最常见的年龄组为 45-65 岁（范围为 57.8%-60.7%）。最常见的种族是白人（63.2%-66.4%），患者主要为男性（69.7%-71.2%）。主要的医疗保健支付者是医疗保险（29.4%-30.7%）和医疗补助（21.5%-32.5%）。最常见的地理位置是美国南部（33.6%-34.4%）。大多数患者被收入三级保健中心（50.2%-62.3%），位于城市地区。在这个住院患者样本中，AH 的死亡率在 2011 年为 5.3%，在 2017 年为 5.5%。最常见的与死亡相关的风险因素是急性肾衰竭（59.6%-72.1%）和胃肠道出血（17.2%-20.3%）。总费用在 25242.62 美元至 34874.50 美元之间。
从 2011 年到 2017 年，AH 住院人数显著增加。这可能会对医疗保健成本和利用率的增加产生重大的财务影响。AH 的死亡率保持不变。
