Table 4.
Independent association between MOUD* and all-cause mortality in patients with cirrhosis and active opioid use disorder; overall and stratified by baseline decompensation status
| Overall | Compensated | Decompensated | ||||
|---|---|---|---|---|---|---|
|
| ||||||
| Covariate | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value |
|
| ||||||
|
| ||||||
| MOUD | 1.21 (0.96, 1.52) | 0.099 | 1.20 (0.92, 1.57) | 0.172 | 1.31 (0.81, 2.11) | 0.267 |
|
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|
| ||||||
| Demographics | ||||||
|
| ||||||
| Age (per year) | 1.03 (1.01, 1.04) | <0.001 | 1.03 (1.01, 1.04) | <0.001 | 1.02 (0.99, 1.05) | 0.249 |
|
| ||||||
| BMI | 0.99 (0.98, 1.01) | 0.274 | 1.00 (0.98, 1.01) | 0.619 | 0.97 (0.94, 1.01) | 0.120 |
|
| ||||||
| Race/Ethnicity (vs. Non-Hispanic White) | ||||||
| Non-Hispanic Black | 0.72 (0.61, 0.86) | <0.001 | 0.70 (0.57, 0.87) | 0.001 | 0.86 (0.56, 1.34) | 0.508 |
| Hispanic | 1.05 (0.87, 1.28) | 0.606 | 0.99 (0.76, 1.27) | 0.922 | 1.57 (0.95, 2.60) | 0.079 |
| Other race/ethnicity | 0.84 (0.57, 1.24) | 0.385 | 0.93 (0.61, 1.42) | 0.739 | 0.73 (0.29, 1.84) | 0.508 |
|
| ||||||
| Female | 0.66 (0.33, 1.32) | 0.243 | 0.62 (0.26, 1.47) | 0.275 | 0.64 (0.14, 2.93) | 0.570 |
|
| ||||||
| Marital status (vs. married) | ||||||
| Single | 0.97 (0.76, 1.23) | 0.782 | 0.97 (0.74, 1.27) | 0.825 | 1.05 (0.59, 1.86) | 0.880 |
| Divorced/widowed | 1.09 (0.89, 1.35) | 0.403 | 1.08 (0.87, 1.35) | 0.484 | 1.32 (0.80, 2.16) | 0.279 |
|
| ||||||
| Homeless | 0.93 (0.71, 1.20) | 0.564 | 0.91 (0.68, 1.23) | 0.544 | 0.85 (0.56, 1.28) | 0.429 |
|
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|
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| Liver Disease Factors | ||||||
|
| ||||||
| Hepatitis C virus | 1.26 (1.02, 1.55) | 0.033 | 1.16 (0.93, 1.46) | 0.196 | 1.83 (1.04, 3.21) | 0.035 |
|
| ||||||
| Prior hepatic decompensation | 1.82 (1.49, 2.22) | <0.001 | n/a | n/a | ||
|
| ||||||
| Hepatocellular carcinoma | 2.26 (1.54, 3.32) | <0.001 | 2.74 (1.89, 3.98) | <0.001 | 1.53 (0.74, 3.18) | 0.253 |
|
| ||||||
| MELD (per point) | 1.05 (1.03, 1.07) | <0.001 | 1.05 (1.03, 1.07) | <0.001 | 1.03 (1.00, 1.06) | 0.034 |
|
| ||||||
| Prior hepatitis C treatment | 1.03 (0.72, 1.47) | 0.875 | 1.00 (0.67, 1.50) | 0.993 | 1.25 (0.59, 2.65) | 0.565 |
|
| ||||||
|
| ||||||
| Substance Use Disorders | ||||||
|
| ||||||
| Nicotine use disorder | 1.00 (0.86, 1.16) | 0.969 | 0.95 (0.79, 1.15) | 0.607 | 1.11 (0.74, 1.65) | 0.614 |
|
| ||||||
| Alcohol use disorder | 1.26 (1.08, 1.47) | 0.003 | 1.39 (1.15, 1.66) | <0.001 | 0.90 (0.63, 1.30) | 0.586 |
|
| ||||||
| Other substance use disorders | 1.08 (0.91, 1.28) | 0.392 | 1.04 (0.86, 1.26) | 0.675 | 1.38 (0.95, 1.99) | 0.089 |
|
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|
| ||||||
| Other Comorbidities | ||||||
|
| ||||||
| Pain related diagnoses | 0.91 (0.76, 1.08) | 0.260 | 0.92 (0.75, 1.12) | 0.390 | 0.94 (0.68, 1.31) | 0.709 |
|
| ||||||
| Opioid prescription | 1.04 (0.87, 1.25) | 0.650 | 1.03 (0.83, 1.29) | 0.757 | 1.14 (0.77, 1.68) | 0.513 |
|
| ||||||
| Mood disorders | 0.91 (0.77, 1.06) | 0.223 | 0.86 (0.72, 1.01) | 0.073 | 1.15 (0.82, 1.62) | 0.412 |
|
| ||||||
| Anxiety disorders | 0.79 (0.63, 1.00) | 0.048 | 0.77 (0.61, 0.99) | 0.042 | 0.89 (0.53, 1.52) | 0.679 |
|
| ||||||
| Schizophrenia | 0.95 (0.71, 1.27) | 0.744 | 1.01 (0.72, 1.42) | 0.955 | 0.68 (0.34, 1.33) | 0.255 |
|
| ||||||
| Post-traumatic stress disorder | 0.91 (0.76, 1.09) | 0.314 | 0.85 (0.68, 1.07) | 0.164 | 1.07 (0.74, 1.56) | 0.716 |
|
| ||||||
| Charlson Comorbidity Index (per point) | 1.13 (1.06, 1.21) | <0.001 | 1.13 (1.05, 1.20) | 0.001 | 1.16 (1.00, 1.34) | 0.049 |
*
MOUD=Medication treatment for opioid use disorder; BMI=body mass index; MELD=Model for end-stage liver disease; HR=hazard ratio; CI=confidence interval