Wang Dennis, Puglia Marco
McMaster University Adult Gastroenterology Residency Program, Hamilton, ON, Canada.
Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
J Can Assoc Gastroenterol. 2023 Nov 30;7(2):169-176. doi: 10.1093/jcag/gwad048. eCollection 2024 Apr.
The management of alcohol-related liver disease requires a multidisciplinary approach to treat alcohol use disorder. We aimed to determine the proportion of actively drinking patients admitted for alcohol-associated hepatitis (AAH) or decompensated alcohol-related cirrhosis (DARLC) who were offered or underwent screening, brief intervention, and referral to treatment (SBIRT) for alcohol use disorder during admission and if inpatient SBIRT is associated with reduced readmissions for alcohol-related liver disease.
We conducted a retrospective cohort study of actively drinking patients admitted to our institution from January 2017 to December 2021 with AAH or DARLC. Logistic regression was used to identify factors, such as conducting SBIRT, that were associated with 30-day and 90-day readmissions for recurrent AAH or DARLC.
There were 120 AAH admissions (mean age 47.7 ± 13.6 years), and 177 DARLC admissions (mean age 58.2 ± 9.5 years). SBIRT was conducted in only 51.7% of AAH admissions, and 23.7% of DARLC admissions. For AAH, conducting SBIRT was associated with significantly reduced 30-day (OR 0.098, = 0.001, 95% CI 0.024-0.408) and 90-day (OR 0.166, = 0.003, 95% CI 0.052-0.534) readmissions. For DARLC, there was no association between conducting SBIRT and 30-day or 90-day readmissions.
SBIRT was conducted with actively drinking patients in only 51.7% of AAH admissions and 23.7% of DARLC admissions. Patients admitted for AAH who received inpatient SBIRT had decreased 30-day and 90-day readmission rates for AAH or DARLC.
酒精性肝病的管理需要多学科方法来治疗酒精使用障碍。我们旨在确定因酒精性肝炎（AAH）或失代偿性酒精性肝硬化（DARLC）入院且仍在积极饮酒的患者在住院期间接受筛查、简短干预及转介治疗（SBIRT）以治疗酒精使用障碍的比例，以及住院SBIRT是否与酒精性肝病再入院率降低相关。
我们对2017年1月至2021年12月期间因AAH或DARLC入住我院且仍在积极饮酒的患者进行了一项回顾性队列研究。采用逻辑回归分析来确定与复发性AAH或DARLC的30天和90天再入院相关的因素，如进行SBIRT。
有120例AAH入院患者（平均年龄47.7±13.6岁），177例DARLC入院患者（平均年龄58.2±9.5岁）。仅51.7%的AAH入院患者和23.7%的DARLC入院患者接受了SBIRT。对于AAH，进行SBIRT与30天（比值比0.098，P = 0.001，95%置信区间0.024 - 0.408）和90天（比值比0.166，P = 0.003，95%置信区间0.052 - 0.534）再入院率显著降低相关。对于DARLC，进行SBIRT与30天或90天再入院之间无关联。
仅51.7%的AAH入院患者和23.7%的DARLC入院患者接受了SBIRT。接受住院SBIRT的AAH入院患者的AAH或DARLC 30天和90天再入院率有所降低。
