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

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Abstract

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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Abbreviations

ALD:

Alcohol-related liver disease

AAH:

Acute alcohol-related hepatitis

ALC:

Alcohol-related liver cirrhosis

AFLD:

Alcohol-related fatty liver disease

AL:

Alcohol-related pancreatitis

AAP:

Acute alcohol-related pancreatitis

ACP:

Alcohol-related chronic pancreatitis

AUD:

Alcohol use disorder

DALYs:

Disease-adjusted life years

ICD:

International Classification of Diseases

UPMC:

University of Pittsburgh Medical Center

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Acknowledgment

The authors thank the Enhancing MEntoring to Improve Research in GastroEnterology (EMERGE) Program of the Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, and the Collaborative Alliance of Pancreas Education and Research (CAPER) Scholars Program for supporting this project.

Funding

DY (UO1 DK108306, DoD PR 182623); AAD (R01 CA19710 (NIH), W81XWH-15-1-0663 (DoD), R01 CA235730-01 (NIH), U01 GM132133 (NIH), R61 HL144669-01 (NIH), R21 TR003094-01 (NIH), R34 HL132031—01A1 (NIH); GEA (R01AA021978, R01AA028436 and P30DK120531); RB (U01AA021908 and U01AA020821). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Defense.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Gavin E. Arteel, Ajay Singhvi, Ramon Bataller & Dhiraj Yadav

  2. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Robert Feldman & Andrew D. Althouse

  3. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Melissa Saul

  4. University of Pittsburgh Medical Center, 200 Lothrop St, M2, C-Wing, Pittsburgh, PA, 15213, USA

    Dhiraj Yadav

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  1. Gavin E. Arteel
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  2. Ajay Singhvi
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Correspondence to Dhiraj Yadav.

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Supplementary Information

Supplementary Figure 1 Coexistence of alcohol-related diseases based on duration of contact and hospital type - a. ALD in patients diagnosed with AUD; b. ALP in patients diagnosed with AUD; c AUD in patients diagnosed with ALD; d. ALP in patients diagnosed with ALD; e. ALD in patients diagnosed with ALP. ***: <= 0.001, **: <= 0.01, *: <= 0.05.

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Arteel, G.E., Singhvi, A., Feldman, R. et al. Coexistent Alcohol-Related Liver Disease and Alcohol-Related Pancreatitis: Analysis of a Large Health Care System Cohort. Dig Dis Sci 67, 2543–2551 (2022). https://doi.org/10.1007/s10620-021-07010-5

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  • DOI: https://doi.org/10.1007/s10620-021-07010-5

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