Referral to Hepatology Low With Excessive Alcohol Use, High FIB-4

MONDAY, Oct. 7, 2024 (HealthDay News) — Only 37 percent of patients with excessive alcohol use (EAU) and a high fibrosis-4 index (FIB-4) are referred to hepatology, according to a study published online Sept. 21 in Alcohol: Clinical & Experimental Research.

Kevin Houston, M.D., from Virginia Commonwealth University in Richmond, and colleagues extracted records of patients with excessive alcohol use between 2013 and 2023 and compared those referred to versus not referred to hepatology.

Overall, 1,131 individuals showed evidence of EAU, and of these,189 were in alcohol remission; the remaining 942 individuals were further analyzed for FIB-4 score and referral patterns. The researchers found that 316 patients had active EAU and high FIB-4; 37 percent were referred to hepatology. The likelihood of being referred was lower for patients with alcohol-related mental health concerns and those admitted for trauma. Referral was higher with alcohol-related liver hospitalizations and a higher Charlson Comorbidity Index (odd ratios, 9.25 and 6.23, respectively) and was lower with mental health admissions or mental health diagnoses and with increasing age (odds ratios, 0.36, 0.36, and 0.95, respectively).

“Greater education of mental health providers and for teams taking care of inpatients admitted with alcohol-related mental health concerns would better integrate care and could improve outcomes for patients with higher risk for advanced liver disease,” the authors write.

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