Hepatitis C and hospital outcomes in patients admitted with alcohol-related problems

BACKGROUND/AIMS: Alcohol is known to act synergistically with chronic hepatitis C virus (HCV) infection to cause liver disease; however, their combined effect on outcomes in acutely hospitalized patients is less clear. We examined the impact of HCV infection on hospital mortality and length of stay among hospitalized patients with alcohol abuse problems. METHODS: We retrospectively identified 6354 admissions to an urban, public hospital between July 1996 and January 2002 with discharge diagnoses related to alcohol dependence or abuse. Hepatitis C diagnosis and other information were extracted from a clinical database and tested for associations with death and length of hospital stay using multivariable regression techniques. RESULTS: The prevalence of diagnosed HCV infection in this sample of patients with alcohol abuse was 15%. Patients with HCV were about twice as likely to die during hospital admission (4.4 vs. 2.4%; P-value < 0.01), and there appeared to be a trend toward increased mortality even after adjustment for demographics, medical service, homelessness and comorbidities (fully adjusted OR 1.41; 95% CI: 0.97-2.04). Length of stay was significantly longer for patients with HCV (19% longer; 95% CI: 12-27% after adjustment) than those without. CONCLUSIONS: Patients admitted to the hospital with alcohol-related diagnoses have longer hospital stays and are more likely to die in hospital if they have a diagnosis of HCV.