■酒精性肝炎(AH)代表与广泛严重程度相关的酒精性肝病(ALD)的严重表现。ALD与营养缺乏有关,随着酒精滥用和ALD的进展,营养不良的严重程度不断升级。本研究旨在探讨营养不良对AH临床轨迹的影响。
■我们使用2016-2020年国家再入院数据库(NRD)确定了AH入院的成年患者。我们根据营养不良的严重程度对AH患者进行了进一步分类。我们使用多元回归模型比较了AH住院的结果。
■我们包括82,367名AH患者,其中15,693人(19.00%)营养不良。4,243例(5.15%)患者表现出轻度至中度营养不良,5862例(7.07%)患者有严重营养不良,5,588例(6.78%)患者的营养不良严重程度不明。我们发现,营养不良患者因AH导致的调整后住院死亡率更高,对应于营养不良的严重程度(轻度-中度营养不良和重度营养不良的调整比值比[aOR]1.62和3.14,分别;p<0.01)。此外,营养不良患者感染性休克的几率逐渐升高,血管加压药的要求,机械通气,和重症监护病房(ICU)入院,营养不良强度不断升级。肝脏相关并发症,比如自发性细菌性腹膜炎,凝血病,肝肾综合征,和肝性脑病,还发现营养不良的可能性增加。此外,资源利用率随着营养不良严重程度的增加而逐渐增加。
■我们的研究结果表明,营养不良是AH患者常见的合并症,不同程度的严重程度,这与更高的死亡率相关,强调营养状况在AH预后中的关键作用。这些发现强调了解决和管理AH患者营养不良的重要性,不仅因为其对死亡率的潜在贡献,还因为其与一系列并发症和增加的医疗资源利用率相关.
UNASSIGNED: Alcoholic hepatitis (AH) represents a severe manifestation of alcoholic liver disease (ALD) associated with a wide severity spectrum. ALD is linked to nutritional deficiencies, with the gravity of malnutrition escalating as alcohol abuse and ALD progress. This study aims to delve into the impact of malnutrition on the clinical trajectory of AH.
UNASSIGNED: We identified adult patients admitted with AH using the National Readmission Database (NRD) 2016-2020. We further classified AH patients based on the severity of malnutrition. We compared the outcomes of AH hospitalizations using a multivariate regression model.
UNASSIGNED: We included 82,367 AH patients, of whom 15,693 (19.00%) had malnutrition. 4,243 (5.15%) patients exhibited mild to moderate malnutrition, 5,862 (7.07%) patients had severe malnutrition, and 5,588 (6.78%) patients had unspecified severity of malnutrition. We found that adjusted in-hospital mortality due to AH was higher in patients with malnutrition, corresponding to the severity of malnutrition (adjusted odds ratio [aOR] 1.62 and 3.14 in mild-moderate malnutrition and severe malnutrition, respectively; p < .01). Additionally, patients with malnutrition had progressively elevated odds of septic shock, vasopressor requirement, mechanical ventilation, and intensive care unit (ICU) admission with escalating intensity of malnutrition. Liver-related complications, such as spontaneous bacterial peritonitis, coagulopathy, hepatorenal syndrome, and hepatic encephalopathy, were also found to have an increased likelihood in the presence of malnutrition. Furthermore, resource utilization showed a progressive increase with increasing severity of malnutrition.
UNASSIGNED: Our findings indicate that malnutrition is a common comorbidity in AH patients, with varying degrees of severity, which correlates with higher mortality rates, emphasizing the critical role of nutritional status in the prognosis of AH. These findings underscore the importance of addressing and managing malnutrition in patients with AH, not only for its potential contribution to mortality but also because of its association with a spectrum of complications and increased healthcare resource utilization.