Abstract
<title>Abstract</title> <p> <bold>Background:</bold> Alcohol abstinence is the most effective intervention to improve survival in alcohol-associated hepatitis (AH). In 2020 we implemented an inpatient Substance Use Navigation (SUN) program to link hospitalized AH patients to community-based addiction care. The study aim was to evaluate the effect of SUN on post-hospitalization outcomes in AH. <bold>Methods:</bold> This retrospective cohort study included patients with no prior hospitalization for AH in the prior 6 months who survived an index AH admission from February 2020 to April 2024. Patients were stratified into SUN consulted (SUN <sup>+</sup> ), and SUN non-consulted (SUN <sup>−</sup> ) groups. Kaplan-Meier analysis and Cox models were used to assess relationships between SUN utilization, 90-day post-hospital survival, and 30-day readmission rates. Logistic regression was used to identify clinical factors associated with SUN utilization. <bold>Results:</bold> Of 284 patients surviving AH hospitalization, 123 (43.3%) underwent SUN consultation. Logistic regression demonstrated that age, ascites, and ICU admission were associated with reduced SUN consultation, while increased BMI and white race were associated with increased SUN consultation. Age, MELD 3.0, and national area deprivation index (ADI), were associated with reduced 90-day survival, while SUN consultation was associated with improved 90-day survival in multivariate Cox models. Adjusted mean survival was longer in SUN <sup>+</sup> patients (86.6 vs. 68.9[JV1] days, <italic>p</italic> < 0.001). Thirty-day readmission was not affected by SUN consultation. <bold>Conclusion:</bold> SUN consultation was associated with improved 90-day post-hospital survival in patients admitted with AH, independent of liver disease severity. These findings support early SUN utilization in this population. [JV1]Replaced this with the value that was in the results section. </p>