Background and Aims:Alcohol-associated liver disease(ALD)is the most common cause of advanced liver disease worldwide,including in the USA.Alcohol use and cirrhosis mortality is higher in American Indian/Alaska Native...Background and Aims:Alcohol-associated liver disease(ALD)is the most common cause of advanced liver disease worldwide,including in the USA.Alcohol use and cirrhosis mortality is higher in American Indian/Alaska Native(AI/AN)compared to Whites.Data are scanty on ALD as a liver disease etiology in AI/AN compared to other races and ethnicities.Methods:The National Inpatient Sample on 199,748 cirrhosis-related hospitalizations,14,241(2,893 AI/AN,2,893 Whites,2,882 Blacks,2,879 Hispanics,and 2,694 Asians or other races)matched 1:1 for race/ethnicity on demographics,insurance,and income quartile of the residence zip code analyzed.Results:After controlling for geographic location and hospital type,odds ratio(OR)and 95%confidence interval(CI)for ALD as cirrhosis etiology was higher among admissions in AI/AN vs.Whites[1.55(1.37–1.75)],vs.Blacks[1.87(1.65–2.11)],vs.Hispanic[1.89(1.68–2.13)]and Asians/other races[2.24(1.98–2.53)].OR was also higher for AI/AN vs.all other races for alcohol-associated hepatitis(AH)as one of the discharge diagnoses.The findings were similar in a subgroup of 4,649 admissions with decompensated cirrhosis and in a cohort of 350 admissions with acute-on-chronic liver failure as defined by EASL-CLIF criteria.Alcohol use disorder diagnosis was present in 38%of admissions in AI/AN vs.24–30%in other races,p<0.001.A total of 838(5.9%)admissions were associated with in-hospital mortality.OR(95%CI)for in-hospital mortality in AI/AN individuals was 34%reduced vs.Blacks[0.66(0.51–0.84)],but no difference was observed on comparison with other races.Conclusions:ALD,including AH,is the most common etiology among cirrhosisrelated hospitalizations in the USA among AI/AN individuals.In-hospital mortality was observed in about 6%of admissions,which was higher for Blacks and similar in other races compared to admissions for AI/AN.Public health policies should be implemented to reduce the burden of advanced ALD among AI/AN individuals.展开更多
文摘Background and Aims:Alcohol-associated liver disease(ALD)is the most common cause of advanced liver disease worldwide,including in the USA.Alcohol use and cirrhosis mortality is higher in American Indian/Alaska Native(AI/AN)compared to Whites.Data are scanty on ALD as a liver disease etiology in AI/AN compared to other races and ethnicities.Methods:The National Inpatient Sample on 199,748 cirrhosis-related hospitalizations,14,241(2,893 AI/AN,2,893 Whites,2,882 Blacks,2,879 Hispanics,and 2,694 Asians or other races)matched 1:1 for race/ethnicity on demographics,insurance,and income quartile of the residence zip code analyzed.Results:After controlling for geographic location and hospital type,odds ratio(OR)and 95%confidence interval(CI)for ALD as cirrhosis etiology was higher among admissions in AI/AN vs.Whites[1.55(1.37–1.75)],vs.Blacks[1.87(1.65–2.11)],vs.Hispanic[1.89(1.68–2.13)]and Asians/other races[2.24(1.98–2.53)].OR was also higher for AI/AN vs.all other races for alcohol-associated hepatitis(AH)as one of the discharge diagnoses.The findings were similar in a subgroup of 4,649 admissions with decompensated cirrhosis and in a cohort of 350 admissions with acute-on-chronic liver failure as defined by EASL-CLIF criteria.Alcohol use disorder diagnosis was present in 38%of admissions in AI/AN vs.24–30%in other races,p<0.001.A total of 838(5.9%)admissions were associated with in-hospital mortality.OR(95%CI)for in-hospital mortality in AI/AN individuals was 34%reduced vs.Blacks[0.66(0.51–0.84)],but no difference was observed on comparison with other races.Conclusions:ALD,including AH,is the most common etiology among cirrhosisrelated hospitalizations in the USA among AI/AN individuals.In-hospital mortality was observed in about 6%of admissions,which was higher for Blacks and similar in other races compared to admissions for AI/AN.Public health policies should be implemented to reduce the burden of advanced ALD among AI/AN individuals.
