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COVID-19 PANDEMIC IMPACT ON ALCOHOLIC HEPATITIS HEALTHCARE UTILISATION
Gastroenterology ; 162(7):S-1278, 2022.
Article in English | EMBASE | ID: covidwho-1967444
ABSTRACT
Background and

Aims:

Alcoholic hepatitis (AH) is associated with significant morbidity, mortality and healthcare expenditure. The global SARS-CoV-2 (COVID-19) pandemic and related lockdown measures have potentially contributed to an increase in alcohol misuse. This study examines frequency and patient outcomes of AH admissions to an Australian quaternary liver transplant referral centre. We aimed to ascertain the change in AH severity, ICU admission rates and healthcare utilisation costs over the last 5 years to identify temporal associations with the COVID-19 pandemic.

Methods:

A retrospective analysis of patients aged 18 years and older fulfilling National Institute on Alcohol Abuse and Alcoholism diagnostic criteria for AH between January 2016 and March 2021 was conducted. Data were collected from electronic medical records and analysed. Primary endpoints were the frequency of AH admissions, ICU admission rates and healthcare costs, which were evaluated with a divergence at the beginning of lockdown restrictions (March 2020 – March 2021 “COVID cohort”) versus the “historical cohort” (January 2016 - February 2020).

Results:

In total, 105 eligible AH admissions were identified. Overall, 90 day mortality was 18% (19/105). AH admission rate for the COVID cohort was significantly higher at 3.38 cases/month (n = 44) compared to the historical cohort at 1.22 cases/month (n = 61), p < 0.001. The COVID cohort had greater disease severity with a higher Glasgow Alcoholic Hepatitis Score during admission [8.5 (IQR 7-10) vs 7 (IQR 6-9), p = 0.04]. The AH COVID cohort trended towards a greater proportion requiring ICU admission, inotropic support and longer ICU length of stay. Whilst per-episode adjusted healthcare costs were similar across the study, monthly costs of the COVID cohort were higher compared to the historical cohort due to increased admission frequencies [mean (SD) ≥137,549 (54,058) vs ≥38,000 (27,448), p = 0.02 (Figure 1)]. No patients in this study were diagnosed with COVID-19.

Conclusion:

In this study, alcoholic hepatitis admission frequency and healthcare costs were found to have increased since the COVID-19 pandemic. These observations provide the impetus for future studies to understand how the COVID-19 pandemic has led to increased AH presentations and develop preventative strategies that reduce alcohol related admissions and associated costs (Figure Presented)
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Gastroenterology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Gastroenterology Year: 2022 Document Type: Article