SEX differences in alcohol-associated hepatitis (AH) severity and outcomes were highlighted in a retrospective study using ICD-9-CM and ICD-10-CM codes, with findings showing that females face higher risks of sepsis and mechanical ventilation during hospitalization compared to males.
The study evaluated 1,386 inpatient encounters at the University of Kentucky from 2012 to 2021, including 511 females and 875 males. Both groups shared similar baseline characteristics, such as race and liver disease severity scores, yet important differences emerged in complications and outcomes. Females experienced significantly higher rates of urinary tract infections, sepsis, and norepinephrine use, while males showed a higher incidence of esophageal variceal bleeding.
Multivariate analysis demonstrated that female patients had a 41% greater odds of sepsis and a 35% greater odds of requiring mechanical ventilation. Importantly, mortality risk increased substantially for any patient encountering sepsis or requiring ventilation, with odds ratios of 2.3 and 9.3, respectively. These results underscore the role of secondary complications as critical drivers of poor outcomes in AH.
The findings reinforce the need for clinicians to be aware of sex-based differences in alcohol-associated hepatitis. While baseline disease severity was similar across sexes, females had elevated risks for sepsis and invasive interventions, highlighting a potential gap in tailored management strategies. The authors emphasize that further research is necessary to determine whether sex-specific treatment approaches could improve outcomes for women with AH.
Reference: Harris E et al. Sex differences in severity, outcomes, and healthcare utilization in alcohol-associated hepatitis. World J Hepatol. 2025;17(8):108063.
