Research Day
INFLUENCE OF ALCOHOL ON HOSPITAL ADMISSIONS, IN-HOSPITAL DEATH, AND LIVER TRANSPLANT FOR PATIENTS WITH WILSON DISEASE: NIS ESTIMATES FROM 2002-2014
Document Type
Abstract
Date
2021
Abstract
Background: Wilson disease (WD) is an uncommon genetic disorder of copper metabolism that causes liver damage. Alcohol consumption can compound hepatotoxicity in these patients. The implications of alcohol use in WD have not been described; we performed this study to estimate how alcohol can affect liver disease in patients hospitalized with WD.
Methods: Using the National Inpatient Sample database, we investigated the association between alcohol use and in-hospital outcomes in WD and non-alcoholic liver disease (WD-NALD) in terms of hepatitis or cirrhosis and in WD with alcoholic liver disease (WD-ALD) in terms of hepatitis, fatty liver disease, or cirrhosis.
Results: Between 2002-2014 there were 19,206 hospital discharges for WD: 15.9% and 5% included diagnoses of WD-NALD and WD-ALD, respectively. In-hospital mortality was 4.14% for WD-NALD and 5.11% for WD-ALD (p=0.409). Median age at admission was 43 years old for WD-NALD and 46 years old for WD-ALD (p=0.0102). Liver transplant was performed for 7.70% and 1.88% of WD-NALD and WD-ALD patients, respectively (p=0.003). Liver failure complications included spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, and hepatorenal syndrome.
Conclusion: We found no statistically significant difference in in-hospital mortality between WD-NALD and WD-ALD. Age at hospital admission was three years younger for WD-NALD versus WD-ALD, which may be due to a delay in diagnosis of WD masked by acute alcoholic liver disease. Alcohol use was associated with a more critically ill hospital course once admitted. Physicians should reinforce alcohol avoidance in patients with WD to optimize patient outcomes.