S2702 Epidemiology and Outcomes of Alcoholic Hepatitis in Young Adults: An Analysis of the National Inpatient Sample (2020-2022)

Introduction: Alcoholic hepatitis (AH) is a serious complication of alcohol use disorder, traditionally seen in older populations. However, recent shifts in alcohol consumption patterns, especially during the COVID-19 pandemic, have raised concern about increasing disease burden among young adults. This study investigates the characteristics and outcomes of AH hospitalizations among U.S. adults aged 18–50. Methods: We conducted a retrospective cross-sectional study using the National Inpatient Sample (2020–2022). Adult hospitalizations with a principal diagnosis of AH (International Classification of Diseases, Tenth Revision: K70.10, K70.11) were included. Outcomes in young adults (18–50 years) were compared to those >50 years using survey-weighted analyses. Multivariable regression models were constructed to identify predictors of mortality, length of stay (LOS), and hospital charges in young adults. Results: Among an estimated 65,060 adult hospitalizations for AH, 67.7% occurred in young adults. The mean age in this group was 38.4 years, and 43.1% were woman. Most were White (66.5%), Medicaid-insured (48.4%), and admitted to large urban teaching hospitals. Compared to older adults, young patients had lower mortality (2.3% vs 4.6%, P < 0.001), lower AKI rates (15.8% vs 23.5%, P < 0.001), shorter LOS (5.98 vs 6.74 days), and were more likely to be discharged home (77.5% vs 60.6%). Mechanical ventilation use was similar (3.1% vs 3.2%). In multivariable analysis, increasing age within the 18–50 group (OR 1.05, 95% CI 1.02 1.07, P < 0.001) and large hospital size (OR ∼2.1, P < 0.01) predicted higher mortality. Conclusion: Young adults account for most AH hospitalizations in recent years. Although their short term mortality is lower than in older adults, the high complication rate and hospitalization burden highlight the urgent need for targeted prevention and early intervention strategies.