Browsing by Author "Puangsricharoen, Pimpitcha"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Concomitant Psychiatric and Nonalcohol-Related Substance Use Disorders Among Hospitalized Patients with Alcoholic Liver Disease in the United States
    (Wiley, 2018-02) Jinjuvadia, Raxitkumar; Jinjuvadia, Chetna; Puangsricharoen, Pimpitcha; Chalasani, Naga P.; Crabb, David W.; Liangpunsakul, Suthat; Medicine, School of Medicine
    Background Despite that the epidemiological studies on the comorbidity of alcohol misuse and psychiatric disorders have been studied, less is known about the magnitude of these disorders among patients with alcoholic liver disease (ALD). Our aim was to determine the prevalence of psychiatric and substance use disorders among hospitalized ALD patients in the United States. Methods We utilized a single-level clinical classification software to identify patients with ALD and psychiatric/substance use disorders from the 2011 National Inpatient Sample data. The primary outcome was the prevalence of these disorders among hospitalized patients with ALD (n = 74,972) compared to those with chronic liver diseases not caused by alcohol (n = 350,140) and those without underlying liver diseases (n = 1,447,063). Results The prevalence of adjustment disorder, anxiety disorder, posttraumatic stress disorder, and depression was significantly higher among hospitalized patients with ALD when compared to those with chronic liver diseases not caused by alcohol (all with p-values <0.05). Younger age, female gender, and White race were the independent predictors of psychiatric/substance use disorders among hospitalized patients with ALD. Conclusions Hospitalized patients with ALD have significantly high prevalence of concomitant psychiatric and substance abuse disorders when compared to those with chronic liver diseases not caused by alcohol and those without underlying liver diseases. Screening and appropriate intervention should be implemented as part of routine clinical care for these patients.
  • Thumbnail Image
    Item
    Does providing routine liver volume assessment add value when performing CT surveillance in cirrhotic patients?
    (Springer, 2019-07-29) Patel, Milan; Puangsricharoen, Pimpitcha; Arshad, Hafiz Muhammad Sharjeel; Garrison, Sam; Techasatian, Witina; Ghabril, Marwan; Sandrasegaran, Kumar; Liangpunsakul, Suthat; Tann, Mark; Medicine, School of Medicine
    Background: The measurement of liver volume (LV) is considered to be an effective prognosticator for postoperative liver failure in patients undergoing hepatectomy. It is unclear whether LV can be used to predict mortality in cirrhotic patients. Methods: We enrolled 584 consecutive cirrhotic patients who underwent computerized topography (CT) of the abdomen for hepatocellular carcinoma surveillance and 50 age, gender, race, and BMI-matched controls without liver disease. Total LV (TLV), functional LV (FLV), and segmental liver volume (in cm3) were measured from CT imaging. Cirrhotic subjects were followed until death, liver transplantation, or study closure date of July 31, 2016. The survival data were assessed with log-rank statistics and independent predictors of survival were performed using Cox hazards model. Results: Cirrhotic subjects had significantly lower TLV, FLV, and segmental (all except for segments 1, 6, 7) volume when compared to controls. Subjects presenting with hepatic encephalopathy had significantly lower TLV and FLV than those without HE (p=0.002). During the median follow up of 1,145 days, 112 (19%) subjects were transplanted and 131 (23%) died. TLV and FLV for those who survived were significantly higher than those who were transplanted or dead (TLV:1740 vs 1529 vs 1486, FLV 1691 vs 1487 vs 1444,p <0.0001). In the Cox regression model, age, MELD score, TLV or FLV were independent predictors of mortality. Conclusion: Baseline liver volume is an independent predictor of mortality in subjects with cirrhosis. Therefore it may be useful to provide these data while performing routine surveillance CT scan as an important added value. Further studies are needed to validate these findings and to better understand their clinical utility.