Patients hospitalized with alcohol‐related liver disease and prior bariatric surgery are more prone to develop acute‐on‐chronic liver failure

Abstract

AbstractBackground & AimsPatients with a history of bariatric surgery (BS) are susceptible to developing alcohol use disorder. We and others have previously shown that these patients can develop severe alcohol‐related liver disease (ARLD). Our aim was to describe the demographics, co‐morbidities and mortality of a hospitalized population diagnosed with alcohol‐related liver disease, in relation to BS.MethodsWe included 299 patients hospitalized with ARLD at the Ghent University Hospital between 1 January 2018 and 31 December 2022. Clinical, biochemical and outcome data were retrospectively retrieved from the most recent hospitalization. Statistical analysis was performed using the t test, Mann–Whitney U and χ2 tests.ResultsThirteen per cent (39/299) of patients admitted with ARLD had a history of bariatric surgery, of whom 25 (64.1%) had undergone Roux‐en‐Y gastric bypass. Patients with a history of BS were predominantly female (76.9%), in contrast to the non‐BS population (29.2%) (p < .0001), and despite being significantly younger (p < .0001) and had a similar survival (61.5% vs. 58.1%). Bariatric surgery and older age at diagnosis were both significantly associated with poorer transplant‐free survival. The cause of death was acute‐on‐chronic liver failure in 73.3% of BS patients, compared to only 19.2% of those without a history of BS (p < .0001). The weekly amount of alcohol consumed (p = .012) and duration of use (p < .0001) were significantly lower/shorter in the BS population.ConclusionsBS patients hospitalized with ARLD are predominantly younger women with a lower cumulative alcohol consumption compared to those without prior BS. BS impacted transplant‐free survival, with ACLF as the predominant cause of death in these patients.