Alcohol Rehabilitation Within 3 Months after Alcohol Hepatitis and Survival - A National Analysis - Université de Picardie Jules Verne
Article Dans Une Revue Clinical Gastroenterology and Hepatology Année : 2024

Alcohol Rehabilitation Within 3 Months after Alcohol Hepatitis and Survival - A National Analysis

Philippe Sogni
  • Fonction : Auteur

Résumé

Background and aims There is limited understanding of the benefits of alcohol rehabilitation after alcohol hepatitis (AH). Methods We conducted a 2012-2021 national longitudinal study involving adult inpatients diagnosed with AH in France. We assessed the primary outcome of liver transplantation or death within one year after AH, including in its complicated form (CAH) defined as ≥ 2 hepatic or extrahepatic complications within 4 weeks after AH. The primary exposure was in-hospital alcohol rehabilitation within 3 months following AH. Patients who died (6.5%, n=5,282) or were censored (12.5%, n=10,180) ≤ 4 weeks after AH were excluded. We measured adjusted hazard ratios (aHR) and odds ratios (aOR) within the full cohort and propensity-matched samples. Results Among 65,737 patients (median age 52; IQR 44–60; 76% male), 12% died or underwent liver transplantation. In-hospital alcohol rehabilitation was noted for 25% of patients (15.2% among CAH patients) and was the primary discharge diagnosis for 13.3%. The one-year transplant-free survival rates were 94% (95% CI: 94% to 95%) for rehabilitated patients, compared to 85% (85% to 86%) for those without [aHR 0.62 (0.57 to 0.69) p < 0.001]. Among CAH patients, transplant-free survival was 78% (76% to 81%) with rehabilitation versus 70% (69% to 71%) without [aHR 0.82 (0.68 to 0.98) p = 0.025]. In propensity-matched samples, rehabilitation was linked to an aOR of 0.54 (0.49 to 0.55, p < 0.001) overall, and 0.73 (0.60 to 0.89, p = 0.002) among matched CAH patients. Conclusions In-hospital alcohol rehabilitation within 3-months after AH and CAH improve transplant-free survival rate but remain underutilized.
Fichier non déposé

Dates et versions

hal-04687148 , version 1 (04-09-2024)

Identifiants

Citer

Lucia Parlati, Charlotte Mouliade, Eric Nguyen Khac, Mathis Collier, Stylianos Tzedakis, et al.. Alcohol Rehabilitation Within 3 Months after Alcohol Hepatitis and Survival - A National Analysis. Clinical Gastroenterology and Hepatology, 2024, ⟨10.1016/j.cgh.2024.07.037⟩. ⟨hal-04687148⟩
24 Consultations
0 Téléchargements

Altmetric

Partager

More