title: Hepatitis C and hospital outcomes in patients admitted with alcohol-related problems.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of General Medicine, General Internal Medicine Section (111A1), San Francisco Veteran Administration Medical Center, University of California, 4150 Clement Street, San Francisco, CA 94121, USA. judith.tsui@med.va.gov
authors.forename: Judith I
authors.initials: JI
authors.lastname: Tsui
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pletcher
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Karen
authors.initials: K
authors.lastname: Seal
authors.forename: Ralph
authors.initials: R
authors.lastname: Gonzales
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies