Clinical features of alcoholic hepatitis in latinos and caucasians: A single center experience

Table 1 Patient Characteristics n (%)

	Caucasian (n = 137)	Latino (n = 64)	All Patients (n = 201)	P value
Age of presentation with AH (yr)				0.082
mean ± SD	49.5 (10.4)	46.8 (10.1)	48.6 (10.4)
Sex				0.049
Male	77 (56.2)	46 (71.9)	123 (61.2)
Female	60 (43.8)	18 (28.1)	78 (38.8)
BMI				0.167
mean ± SD	28.1 (5.9)	29.4 (6.2)	28.5 (6)
DM				0.061
No	105 (76.6)	41 (64.1)	146 (72.6)
Yes	25 (18.2)	20 (31.2)	45 (22.4)
Unknown	7 (5.1)	3 (4.7)	10 (5)
Metabolic syndrome				0.405
No	37 (27)	13 (20.3)	50 (24.9)
Yes	53 (38.7)	28 (43.8)	81 (40.3)
Unknown	47 (34.3)	23 (35.9)	70 (34.8)
Duration of drinking (yr)				0.027
mean ± SD	20 (12.7)	24.3 (11)	21.6 (12.3)
Pattern of drinking				0.283
Heavy drinking	5 (3.6)	0	5 (2.5)
Binge drinking	130 (94.9)	64 (100.0)	194 (96.5)
Unknown	2 (1.5)	0	2 (1.0)
Number of drinks/d				0.093
mean ± SD	13.9 (10.9)	16.1 (7.2)	14.6 (9.9)
None	100 (73.0)	37 (57.8)	137 (68.2)
Cocaine	2 (1.5)	0	2 (1.0)
Heroin	1 (0.7)	0	1 (0.5)
Methamphetamine	1 (0.7)	8 (12.5)	9 (4.5)
Marijuana	9 (6.6)	3 (4.7)	12 (6.0)
Other	2 (1.5)	0	2 (1.0)
Polysubstance abuse	10 (7.3)	9 (14.1)	19 (9.5)
Remote history	6 (4.4)	6 (9.4)	12 (6.0)
Unknown	6 (4.4)	1 (1.6)	7 (3.5)

AH: Alcoholic hepatitis; BMI: Body mass index; DM: Diabetes mellitus.

Table 2 Level of care n (%)

	Caucasian	Latino	All patients	P value
Hospitalization duration (in days)	111	52	163	0.239
mean ± SD	14.4 (12.8)	13.8 (15.9)	14.2 (13.8)
ICU admission	111	52	163	0.756
Yes	39 (35.1)	17 (32.7)	56 (34.4)
No	72 (64.9)	35 (67.3)	107 (65.6)
ICU stay (in days)	39	15	54	0.587
mean ± SD	7.7 (9.9)	12.2 (16.6)	8.9 (12.1)

111 out of the 137 Caucasians and 52 out of 64 Latino Subjects were admitted to the hospital for management of alcoholic hepatitis. The other Caucasians and Latino patients were seen in the ED or outpatient setting. ICU: Intensive care unit.

Table 3 Type of alcoholic hepatitis, parameters of liver injury and treatment n (%)

	Caucasian	Latino	All patients	P value
Type of AH	137	64	201	0.321
Acute AH with no history of cirrhosis	94 (68.6)	49 (76.6)	143 (71.1)
AH on chronic cirrhosis	43 (31.4)	15 (23.4)	58 (28.9)
DF score at day 0	137	64	201	0.794
mean ± SD	47.7 (37.2)	46.6 (22.1)	47.3 (33.1)
DF < 32	44 (32.1)	12 (18.8)	56 (27.9)
DF > 32	93 (67.9)	52 (81.2)	145 (72.1)
Initial MELD score	137	64	201	0.661
mean ± SD	21.1 (7)	21.6 (6.7)	21.3 (6.9)
< 9	2 (1.5)	0	2 (1)
10-19	61 (44.5)	30 (46.9)	91 (45.3)
20-29	53 (38.7)	25 (39.1)	78 (38.8)
30-39	19 (13.9)	9 (14.1)	28 (13.9)
> 40	2 (1.5)	0	2 (1.0)
Glasgow AH score at day 0				0.991
mean ± SD	7.5 (1.6)	7.4 (1.5)	7.5 (1.6)
< 9	109 (71.7)	53 (69.7)	162 (71.1)
> 9	43 (28.3)	23 (30.3)	66 (28.9)
Type of treatment	37	15	52	0.862
Steroids	16 (11.7)	8 (12.5)	24 (11.9)
Pentoxifylline	13 (9.5)	4 (6.2)	17 (8.5)
Both	8 (5.8)	3 (4.7)	11 (5.5)
Lille score after 7 d				0.829
< 0.45	18 (13.1)	8 (12.5)	26 12.9)
> 0.45	17 (12.4)	6 (9.4)	23 (11.4)

AH: Alcoholic hepatitis; MELD: Model for end stage liver disease; DF: Maddrey discriminant function is defined as DF = 4.6 x [prothrombin time (s) - control prothrombin time (s)] + (serum bilirubin in mg/dL)[11].

Table 4 Complications associated with alcoholic hepatitis n (%)

	Caucasian	Latino	All patients	P value
Development of respiratory failure	137	64	201	0.687
Yes	13 (9.5)	8 (12.5)	21 (10.4)
No	124 (90.5)	56 (87.5)	180 (89.6)
Development of acute pancreatitis				0.413
No	110 (80.3)	52 (81.2)	162 (80.6)
Yes	13 (9.5)	3 (4.7)	16 (8.0)
Unknown	14 (10.2)	9 (14.1)	23 (11.4)
Development of AKI				0.520
Yes	33 (24.1)	19 (29.7)	52 (25.9)
No	104 (75.9)	45 (70.3)	149 (74.1)
Hepatorenal syndrome				0.328
No	119 (86.9)	60 (93.8)	179 (89.1)
Yes, type 1	15 (10.9)	3 (4.7)	18 (9.0)
Yes, type 2	3 (2.2)	1 (1.6)	4 (2.0)
Development of DIC				0.497
Yes	3 (2.2)	0	3 (1.5)
No	89 (65)	50 (78.1)	139 (69.2)
Unknown	45 (32.8)	14 (21.9)	59 (29.4)

AKI: Acute kidney injury; DIC: Disseminated intravascular coagulation.

Table 5 Cox proportional hazards analyses of overall survival by subject characteristics¹

	All subjects		Caucasian subjects		Latino subjects
	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
History of GI bleeding: yes vs no	0.79 (0.49, 1.28)	0.339	0.91 (0.53, 1.54)	0.718	0.39 (0.09, 1.72)	0.213
History of SBP: yes vs no	0.95 (0.50, 1.80)	0.874	0.86 (0.37, 2.01)	0.727	0.98 (0.37, 2.62)	0.97
ICU Admission: yes vs No	1.32 (0.80, 2.19)	0.278	1.42 (0.79, 2.56)	0.237	1.31 (0.45, 3.81)	0.618
MELD score2	1.88 (1.39, 2.55)	< 0.001	1.86 (1.29, 2.69)	0.001	2.15 (1.19, 3.87)	0.011
Child-turcotte-pugh score: C vs A or B	2.85 (1.62, 5.00)	< 0.001	2.62 (1.36, 5.07)	0.004	4.3 (1.24, 14.9)	0.021
Initial glasgow score: > 9 vs < 9	1.86 (1.18, 2.93)	0.008	1.6 (0.93, 2.74)	0.091	2.91 (1.21, 6.97)	0.017
Initial maddrey score: > 32 vs < 32	2.41 (1.29, 4.49)	0.006	1.82 (0.95, 3.50)	0.072	3	3
Treatment with steroids: yes vs no	1.63 (0.89, 2.98)	0.113	1.68 (0.81, 3.51)	0.164	2.05 (0.61, 6.88)	0.247
Duration of treatment with steroids: ≥ 28 d vs < 28 d	2.23 (0.66, 7.58)	0.198	5.28 (0.69, 40.5)	0.110	1.03 (0.01, 83.3)	0.988
Renal function: CKD 1 or higher vs CKD 0	7.43 (2.74, 20.1)	< 0.001	7.74 (2.8, 21.4)	< 0.001	3	3
Hepatorenal syndrome: yes vs no	7.07	< 0.001	7.77	< 0.001	5.65	0.006
	(3.95, 12.7)		(3.92, 15.4)		(1.66, 19.2)

¹A separate analysis was conducted for each risk factor shown. All analyses were adjusted for age, sex, BMI, and, for analyses in all subjects, ethnicity;

²Change in hazard of death for 10 point increase in actual MELD score;

³Not enough data to analyze. GI bleeding: Gastrointestinal bleeding; SBP: Spontaneous bacterial peritonitis; ICU: Intensive care unit; MELD: Model for end stage liver disease; CKD: Chronic kidney disease.