Work

The role of the hepatologist in the alcohol-associated liver disease epidemic

Year: 2026

Type: article

Abstract: Plain Language Summary Background: We analyzed early outcomes regarding the impact of our integrated alcohol-associated liver disease (ALD) clinic on patients with ALD and alcohol use. Methods: We conducted a retrospective study of patients with ALD who were evaluated in our integrated clinic from May 1, 2022, to December 31, 2023. Primary outcomes included differences in baseline clinical/demographic data between patients who accepted versus declined an appointment and changes in the severity of ALD, alcohol consumption, functional status, hospital utilization, and remission in alcohol use disorder for evaluated patients. Results: Patients who declined appointments (n=66) had higher median no-show rates (15.0 [8.0,30.0] vs. 8.5 [3.25,15.0], p<0.001), social vulnerability index (0.53 [0.26,0.79] vs. 0.38 [0.17,0.63], p=0.033), and proportions of cirrhosis (78.8% vs. 59.8%, p=0.017) versus evaluated patients. Comparison of baseline to first follow-up visit for evaluated patients (n=102) demonstrated significant reductions in median AST (59.5 [41.75, 89] vs. 44.5 [33.5, 56.25], p<0.001), alanine-aminotransferase (33.5 [20,45.25] vs. 26.5 [18.75,33.0], p=0.017), total bilirubin (1.6 [0.7,3.3] vs. 1 [0.5,1.9], p=0.001), phosphatidylethanol (263 [35, 784] vs. 0 [0, 163], p<0.001), MELD-3.0 and Sodium scores for patients with alcohol-associated hepatitis and cirrhosis (16 [11, 18.75] vs. 12 [9, 14], p<0.001), 14 [9.25, 17.75] vs. 11 [8.5, 14], p<0.001), and Child-Turcotte-Pugh scores for patients with cirrhosis (9 [6, 10.5] vs. 7 [6, 9], p<0.001). The proportion of patients with active-severe alcohol use disorder significantly decreased (85.2% vs. 51.9%, p<0.001). Additionally, patients had significant reductions in emergency department utilization (incidence rate ratio of 0.64 emergency department visits/month (p=0.002) and 0.71 hospital admissions/month (p=0.025). However, after considering the false discovery rate, the reduction in hospitalization admissions/month was not statistically significant (False Discovery Rate adjusted p=0.056). Conclusions: Our integrated approach led to reductions in liver injury, degree of liver decompensation, alcohol use, and ED utilization, and remission in AUD in a population of both non-transplant ALD and post-transplant patients. Export Plain Language SummaryThis study looked at the impact of an integrated clinic for patients with alcohol-associated liver disease (ALD) and alcohol use. It found that patients who attended the clinic showed significant improvements in liver function, reduced alcohol consumption, and fewer emergency department visits. Those who declined appointments had higher no-show rates and more severe liver conditions. Evaluated patients showed reductions in key liver injury markers and alcohol use disorder severity. The clinic's approach appears effective in improving health outcomes for ALD patients, though the reduction in hospital admissions was not statistically significant after adjusting for false discovery rates. Text is machine generated and may contain inaccuracies. FAQ

Source: Hepatology Communications

DOI: 10.1097/hc9.0000000000000898

Authors: Gonzalo Gómez Perdiguero, Luis Antonio Díaz, Sebastián Marciano

Institutions: Hospital Italiano de Buenos Aires, Pontificia Universidad Católica de Chile, University of California San Diego

Language: English

Topic: Alcohol Consumption and Health Effects

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,700