4.4 Article

Coexistent Alcohol-Related Liver Disease and Alcohol-Related Pancreatitis: Analysis of a Large Heath Care System Cohort

Journal

DIGESTIVE DISEASES AND SCIENCES
Volume 67, Issue 6, Pages 2543-2551

Publisher

SPRINGER
DOI: 10.1007/s10620-021-07010-5

Keywords

Alcohol; Alcoholism; Liver disease; Pancreatitis; Cirrhosis; Hepatitis

Funding

  1. DoD [PR 182623, W81XWH-15-1-0663]
  2. NIH [R01 CA19710, R01 CA23573001, U01 GM132133, R61 HL144669-01, R21 TR003094-01, R34 HL132031-01A1, R01AA021978, R01AA028436, P30DK120531, U01AA021908, U01AA020821]
  3. [UO1 DK108306]

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The study investigated the prevalence and coexistence of ALD and ALP in patients with an alcohol use disorder, highlighting a higher risk for ALP in the presence of ALD among blacks. Further research is needed to define the clinical impact of coexistent disease on presentation and outcomes.
Introduction Although coexistence of alcohol-related liver disease (ALD) and pancreatitis (ALP) is seen in clinical practice, a clear understanding of the overlap between these diseases is lacking. Moreover, the relative risks for certain population groups have not been studied. We determined the prevalence and coexistence of ALD and ALP in patients with an alcohol use disorder using retrospective analysis of a large patient cohort from Western Pennsylvania. We specifically emphasized the analysis of underrepresented populations, including women and blacks. Methods We identified all unique patients who received care in UPMC health system during 2006-2017 with at least one International Classification of Diseases versions 9 and/or 10 codes for alcohol misuse, ALD and pancreatitis. We noted their sex, race and age of first diagnosis and duration of contact. Results Among 89,774 patients that fit our criteria, the prevalence of ALD, ALP and coexistent ALD and ALP in patients with alcohol misuse was 11.7%, 7.4% and 2.5%, respectively. Prevalence of ALP in ALD was 16.4%, and ALD in ALP was 33.1%. Prevalence of ALP in ALD was slightly more prevalent in women (18.6% vs. 15.6%, p < 0.001). Prevalence of ALP in ALD was 2-4 folds greater in blacks than other races. Discussion A sizeable fraction of patients with ALD or ALP has coexistent disease. This is the first study to identify that blacks are at a higher risk for ALP in the presence of ALD. Future studies should define the clinical impact of coexistent disease on clinical presentation and short- and long-term outcomes.

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