{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:59:30Z","timestamp":1790654370221,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Alcohol\u2010associated liver disease frequently presents late as decompensated cirrhosis, representing a missed opportunity for intervention. Extrahepatic alcohol\u2010related presentations requiring acute care, such as alcohol\u2010associated pancreatitis and alcohol withdrawal syndrome, may identify heavy drinkers at varying risk for liver disease progression. Whether these presentations differentially predict progression to advanced chronic liver disease is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used a United States federated database. Adults with a first diagnosis of alcohol\u2010associated pancreatitis or alcohol withdrawal syndrome (2016\u20132023) without pre\u2010existing liver disease were included. Cohorts were propensity score\u2013matched on demographics, comorbidities, laboratory values, and medications. The primary outcome was advanced chronic liver disease. Secondary outcomes included all\u2010cause mortality and prescription of medications for alcohol use disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 3201 patients per cohort were analyzed. Over median follow\u2010up of 3.5\u20133.7\u2009years, patients with alcohol\u2010associated pancreatitis had higher rates of advanced chronic liver disease (9.3% vs. 7.0%; hazard ratio, 1.29; 95% confidence interval, 1.09\u20131.54;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), driven by hepatic decompensation (7.0% vs. 4.6%; hazard ratio, 1.50; 95% confidence interval, 1.22\u20131.85;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Conversely, patients with alcohol withdrawal syndrome had higher all\u2010cause mortality (12.7% vs. 9.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and medications for alcohol use disorder prescriptions (15.1% vs. 7.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Negative control analyses supported robustness of findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients without pre\u2010existing liver disease, alcohol\u2010associated pancreatitis was associated with 29% higher advanced chronic liver disease risk compared with alcohol withdrawal syndrome and may serve as an early marker of hepatotoxic susceptibility supporting prioritized liver surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70761","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:53:00Z","timestamp":1790653980000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol\u2010Associated Pancreatitis Confers Higher Risk of Advanced Liver Disease Than Alcohol Withdrawal Syndrome"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6909-6328","authenticated-orcid":false,"given":"Butros","family":"Fakhoury","sequence":"first","affiliation":[{"name":"Department of Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7148-5450","authenticated-orcid":false,"given":"Leandro","family":"Sierra","sequence":"additional","affiliation":[{"name":"Department of Medicine Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishan","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyundam","family":"Gu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8540-4930","authenticated-orcid":false,"given":"Luis Antonio","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterolog\u00eda, Escuela de Medicina Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"},{"name":"MASLD Research Center, Division of Gastroenterology and Hepatology University of California San Diego  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-396X","authenticated-orcid":false,"given":"Juan Pablo","family":"Arab","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine Virginia Commonwealth University  Richmond Virginia USA"},{"name":"Departamento de Gastroenterolog\u00eda, Escuela de Medicina Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"17","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1056\/NEJMcp2402121","article-title":"Addressing Alcohol Use","volume":"392","author":"Krist A. H.","year":"2025","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.14309\/ajg.0000000000002572","article-title":"ACG Clinical Guideline: Alcohol\u2010Associated Liver Disease","volume":"119","author":"Jophlin L. L.","year":"2024","journal-title":"American Journal of Gastroenterology"},{"issue":"2","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1001\/jama.2021.7683","article-title":"Diagnosis and Treatment of Alcohol\u2010Associated Liver Disease: A Review","volume":"326","author":"Singal A. K.","year":"2021","journal-title":"JAMA"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-077090","article-title":"Advances in the Understanding and Management of Alcohol\u2010Related Liver Disease","volume":"383","author":"Thursz M.","year":"2023","journal-title":"BMJ"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2025.05.030"},{"key":"e_1_2_9_7_1","volume-title":"Common Alcohol\u2010Related Concerns National Institute on Alcohol Abuse and Alcoholism","author":"Berger D.","year":"2025"},{"issue":"2","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/joim.20026","article-title":"Six\u2010Fold Increased Risk of Acute Pancreatitis in Alcohol\u2010Related Liver Disease Compared to Matched Comparators: A Population\u2010Based Cohort Study","volume":"297","author":"Dugic A.","year":"2025","journal-title":"Journal of Internal Medicine"},{"issue":"9","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.1002\/pds.70198","article-title":"TriNetX Dataworks\u2010USA: Overview of a Multi\u2010Purpose, De\u2010Identified, Federated Electronic Health Record Real\u2010World Data and Analytics Network and Comparison to the US Census","volume":"34","author":"Stein E.","year":"2025","journal-title":"Pharmacoepidemiology and Drug Safety"},{"issue":"1","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-12-9","article-title":"Enhanced Secondary Analysis of Survival Data: Reconstructing the Data From Published Kaplan\u2010Meier Survival Curves","volume":"12","author":"Guyot P.","year":"2012","journal-title":"BMC Medical Research Methodology"},{"issue":"1","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s12874-021-01308-8","article-title":"IPDfromKM: Reconstruct Individual Patient Data From Published Kaplan\u2010Meier Survival Curves","volume":"21","author":"Liu N.","year":"2021","journal-title":"BMC Medical Research Methodology"},{"issue":"3","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.14309\/ajg.0000000000002645","article-title":"American College of Gastroenterology Guidelines: Management of Acute Pancreatitis","volume":"119","author":"Tenner S.","year":"2024","journal-title":"American Journal of Gastroenterology"},{"issue":"6","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.pan.2020.07.412","article-title":"Coexistence of Alcohol\u2010Related Pancreatitis and Alcohol\u2010Related Liver Disease: A Systematic Review and Meta\u2010Analysis","volume":"20","author":"Singhvi A.","year":"2020","journal-title":"Pancreatology"},{"issue":"11","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.cgh.2009.06.010","article-title":"Pancreas and Liver Injury Are Associated in Individuals With Increased Alcohol Consumption","volume":"7","author":"Pace A.","year":"2009","journal-title":"Clinical Gastroenterology and Hepatology"},{"issue":"6","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/S0016-5107(99)70286-5","article-title":"A Prospective Study of Pancreatic Disease in Patients With Alcoholic Cirrhosis: Comparative Diagnostic Value of ERCP and EUS and Long\u2010Term Significance of Isolated Parenchymal Abnormalities","volume":"49","author":"Hastier P.","year":"1999","journal-title":"Gastrointestinal Endoscopy"},{"issue":"47","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"17756","DOI":"10.3748\/wjg.v20.i47.17756","article-title":"Pathogenesis of Alcoholic Liver Disease: Role of Oxidative Metabolism","volume":"20","author":"Ceni E.","year":"2014","journal-title":"World Journal of Gastroenterology"},{"issue":"24","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1001\/jama.2019.19411","article-title":"Diagnosis and Management of Chronic Pancreatitis: A Review","volume":"322","author":"Singh V. 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T.","year":"2023","journal-title":"Asian Pacific Journal of Cancer Prevention"},{"issue":"6","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/cld.1129","article-title":"Diagnosis and Treatment of Alcohol\u2010Associated Liver Disease: A Patient\u2010Friendly Summary of the 2019 AASLD Guidelines","volume":"17","author":"Bertha M.","year":"2019","journal-title":"Clinical Liver Disease (Hoboken)"},{"issue":"12","key":"e_1_2_9_26_1","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1016\/j.addbeh.2013.07.008","article-title":"Goal\u2010Related Outcome After Acute Alcohol\u2010Pancreatitis \u2013 A Two\u2010Year Follow\u2010Up Study","volume":"38","author":"Lappalainen\u2010Lehto R.","year":"2013","journal-title":"Addictive Behaviors"},{"issue":"1","key":"e_1_2_9_27_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/acer.13267","article-title":"Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder","volume":"41","author":"Durazzo T. 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