Liver-related Mortality in Homeless-experienced Adults over a 16-year Period.

INTRODUCTION

The objective of this study was to examine liver-related mortality trends in a large cohort of homeless-experienced adults.

METHODS

We linked a cohort of 60,092 adults who received care at Boston Health Care for the Homeless Program (BHCHP) from 2003-2017 to death occurrence files. We evaluated temporal trends in age-standardized liver-related mortality and identified leading causes of liver-related death compared with the Massachusetts population, reporting standardized mortality rate ratios (SRRs).

RESULTS

Of the 7,130 deaths in the cohort, 652 (9.1%) were liver-related. Liver-related mortality decreased on average 3.5% annually, though remained significantly higher than the Massachusetts population. Leading causes of liver-related death were cirrhosis (n=157, SRR 3.2), liver cancer (n=148, SRR 2.4), alcohol-related liver disease (n=140, SRR 4.4), and viral hepatitis (n=99, SRR 7.2).

CONCLUSION

Efforts to address alcohol use disorder and viral hepatitis in this population may reduce the substantial disparity seen in liver-related mortality in this population.