P3789 - A Comparative Analysis of Rural and Urban Disparities in Alcoholic Hepatitis Outcomes: Insights From the National Inpatient Sample Database

Abhishek Patel, MD¹, Niloy Ghosh, MD², Muhammad A. Nadeem, MD³, Maryam Hussain, MD¹, Abdul Awan, MS⁴, Mohammed Quazi, PhD⁵, Amir Sohail, MD, MSc¹, Abu Baker Sheikh, MD²
1University of New Mexico, Albuquerque, NM; 2University of New Mexico Health Sciences Center, Albuquerque, NM; 3Cleveland Clinic, Cleveland, OH; 4Nishtar Medical University, Multan, Punjab, Pakistan; 5West Virginia University, Morgantown, WV

Introduction: Alcoholic hepatitis is a severe inflammatory liver condition with high mortality, especially in severe cases. While the pathophysiology and management of alcoholic hepatitis have been studied extensively, rural-urban disparities in outcomes remain underexplored. Rural populations often face challenges such as delayed diagnosis and limited access to specialized care. This study examines rural-urban differences in outcomes of alcoholic hepatitis, including mortality, acute kidney injury, mechanical ventilation needs, length of stay, and hospitalization costs.

Methods: This retrospective cohort study utilized the National Inpatient Sample (NIS) database from 2016 to 2021, analyzing 145,770 adult patients diagnosed with alcoholic hepatitis, stratified by rural (n=17,790) and urban (n=127,980) residence. Propensity score matching was performed to create a balanced subset (n=35,580). Multivariable logistic and linear regression models adjusted for demographic, clinical, and hospital-level variables were employed to evaluate in hospital outcomes, including mortality, complications (acute kidney injury, mechanical ventilation), length of stay, and costs.

Results: Rural patients exhibited significantly higher in-hospital mortality (2.81% vs. 2.39%; aOR 1.47, 95% CI 1.05–2.04, p=0.023) and complications such as acute kidney injury (18.27% vs. 11.78%; aOR 2.04, p< 0.001) and mechanical ventilation (3.15% vs. 2.53%; aOR 1.67, p=0.001). Rural patients also experienced longer length of stay (5.72 vs. 5.19 days, p< 0.001) and higher adjusted hospitalization costs (mean $10,548 more, p< 0.001).

Discussion: Rural patients hospitalized with alcoholic hepatitis experience worse outcomes than urban patients, highlighting systemic disparities in care delivery. Strengthening inpatient resources and standardizing management protocols may help reduce these inequities.

Disclosures:
Abhishek Patel indicated no relevant financial relationships.
Niloy Ghosh indicated no relevant financial relationships.
Muhammad Nadeem indicated no relevant financial relationships.
Maryam Hussain indicated no relevant financial relationships.
Abdul Awan indicated no relevant financial relationships.
Mohammed Quazi indicated no relevant financial relationships.
Amir Sohail indicated no relevant financial relationships.
Abu Baker Sheikh indicated no relevant financial relationships.

Abhishek Patel, MD¹, Niloy Ghosh, MD², Muhammad A. Nadeem, MD³, Maryam Hussain, MD¹, Abdul Awan, MS⁴, Mohammed Quazi, PhD⁵, Amir Sohail, MD, MSc¹, Abu Baker Sheikh, MD². P3789 - A Comparative Analysis of Rural and Urban Disparities in Alcoholic Hepatitis Outcomes: Insights From the National Inpatient Sample Database, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.