Patients hospitalized for alcoholic hepatitis (AH) have a high risk of readmission and death. In the present study, researchers sought to identify the factors associated with readmission, alcohol relapse, and mortality.

A retrospective analysis of 135 consecutive patients admitted with AH to a tertiary care hospital between 1999 and 2016 was carried out (test cohort). The findings were confirmed in a prospective analysis of 159 patients in a multi-center AH research consortium from 2013 through 2017 (validation cohort). Alcohol relapse referred to any amount of alcohol consumption within 30 days of hospital discharge. Early alcohol rehabilitation was described as residential or outpatient addiction treatment or mutual support group participation within 30 days of hospital discharge.

• In both the study cohorts, 30-day readmission rates were 30%.
• Alcohol relapse rates were estimated as 37% in the test cohort and 34% in the validation cohort.
• After discharge, 20% in the test cohort and 16% in the validation cohort went on to attend early alcohol rehabilitation.
• Deaths in a median follow-up time of 2.8 years stood at 39%; in a median follow-up of 1.3 years, there were 26% deaths.
• In the test cohort, early alcohol rehabilitation decreased the likelihood of 30-day readmission (adjusted odds ratios [AOR] 0.16; 95% CI, 0.04–0.65; P = .01), 30-day alcohol relapse (AOR, 0.11; 95% CI, 0.02–0.53; P < .001), as well as death (adjusted hazard ratio [AHR], 0.20; 95% CI, 0.05–0.56; P = .001).
• In the validation cohort, early alcohol rehabilitation led to decreased likelihood of 30-day readmission (AOR, 0.30; 95% CI, 0.09–0.98; P = .04), 30-day alcohol relapse (AOR 0.09; 95% CI, 0.01–0.73; P = .02), and death (AHR, 0.20; 95% CI, 0.01–0.94; P = .04).
• A model that combined alcohol rehabilitation and bilirubin noted patients with readmission to the hospital within 30 days with an area under the receiver operating characteristic curve of 0.73.

This evaluation of two cohorts of patients admitted with AH revealed that early alcohol rehabilitation had the potential to decrease the risk of hospital readmission, alcohol relapse, and death.

Source: Peeraphatdit T(B), Kamath PS, Karpyak VM, et al. Alcohol Rehabilitation Within 30 Days of Hospital Discharge Is Associated With Reduced Readmission, Relapse, and Death in Patients With Alcoholic Hepatitis. Clin Gastroenterol Hepatol. 2020;18(2):477-85.e5.