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. 2022 Jul;16(7):689-697.
doi: 10.1080/17474124.2022.2090337. Epub 2022 Jun 19.

The clinical implication of psychiatric illnesses in patients with alcoholic liver disease: an analysis of US hospitals

David Uihwan Lee  1 , Harrison Chou  2 , Edwin Wang  2 , Gregory Hongyuan Fan  2 , John Han  2 , Kevin Chang  2 , Jean Kwon  2 , Ki Jung Lee  2 , Jeremy Blanchard  3 , Nathalie Helen Urrunaga  1
Affiliations

The clinical implication of psychiatric illnesses in patients with alcoholic liver disease: an analysis of US hospitals

David Uihwan Lee et al. Expert Rev Gastroenterol Hepatol. 2022 Jul.

Abstract

Background: In this study, we evaluate the clinical impact of psychiatric illnesses (PI) on the hospital outcomes of patients admitted with alcoholic liver disease (ALD).

Methods: From the National Inpatient Sample from 2012-2017, patients with alcoholic cirrhosis or alcoholic hepatitis were selected and stratified using the presence/absence of PI (which was a composite of psychiatric conditions). The cases were propensity score-matched to PI-absent controls and were compared to the following endpoints: mortality, death due to suicide, length of stay (LOS), hospitalization charges, and hepatic complications.

Results: After matching, there were 122,907 PI with and 122,907 without PI. Those with PI were younger (51.8 vs. 51.9 years p = 0.02) and more likely to be female (39.2 vs. 38.7% p = 0.01); however, there was no difference in race. Patients with PI had lower rates of alcoholic cirrhosis but higher rates of alcoholic hepatitis/alcoholic hepatic steatosis. In multivariate, patients with PI had lower rates of all-cause mortality (aOR 0.51 95%CI 0.49-0.54); however, they experienced higher rates of deaths due to suicide (aOR 3.00 95%CI 1.56-5.78) and had longer LOS (aOR 1.02 95%CI 1.01-1.02).

Conclusion: Presence of PI in ALD patients is associated with prolonged hospital stay and higher rates deaths due to suicide.

Keywords: Alcoholic hepatitis; PI; anxiety; bipolar disorder; depression; schizophrenia.

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Conflict of interest statement

Declaration of Interest Statement:

DU Lee was funded by NIH NIDDK T32 DK067872–17. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1.
Figure 1.
Figure 1 denotes the patient selection procedure of the study.
Figure 2.
Figure 2.
Figure 2 represents the multivariate forest plot using all-cause mortality as the final endpoint, with covariates including psychiatric disorders as independent variables.
Figure 3.
Figure 3.
Figure 3 represents the multivariate forest plot using death due to suicide as the final endpoint, with covariates including psychiatric disorders as independent variables.
See this image and copyright information in PMC

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