Clinical and in-hospital outcomes of alcohol-related pancreatitis in the setting of concomitant alcohol-related hepatitis: A retrospective cohort study.

Abstract

Background: Alcohol misuse is a major cause of acute pancreatitis. When alcohol related hepatitis coexists, the combination of hepatic and pancreatic injury may exacerbate systemic inflammation and organ dysfunction. We evaluated whether concurrent AH influences in hospital outcomes among adults admitted with alcohol induced AP.

Methods: We performed a retrospective cohort study using the NIS database from 2019-2021, identifying adults with alcohol induced AP by ICD 10 codes. Patients were stratified by the presence of concurrent AH. The primary outcome was in hospital mortality. Secondary outcomes were sepsis, acute kidney injury, respiratory failure, pulmonary edema, hepatic encephalopathy, cardiac arrest, pulmonary embolism, malnutrition, length of stay and total hospital charges. Multivariable logistic regression adjusted for demographics and comorbidities.

Results: Among 74,756 admissions for alcohol induced AP, 15.2% had coexistent AH. Patients with AH were younger, more often female, white, and had a longer LOS and higher total charges. In hospital mortality was more prevalent in the AH group. AH remained the strongest predictor of death. AH was independently associated with higher odds of sepsis, AKI, respiratory failure, pulmonary edema, hepatic encephalopathy, cardiac arrest, malnutrition and prolonged LOS. Pulmonary embolism was less frequent in the AH cohort.

Conclusions: Concurrent AH identifies a high risk subset of patients with alcohol induced AP. The presence of AH increases the odds of in hospital death and significantly increases the risk of multiple organ complications and resource utilization. Early recognition of AH, careful supportive care, and multidisciplinary management may mitigate adverse outcomes in this vulnerable population.