Abstracts of the 2025 Annual Meeting of the ALEH
More infoPeople experiencing homelessness (PEH) face disproportionate health risks, yet data on liver disease and its impact in this population remain scarce in Latin America. This study aimed to describe liver-related risk factors, comorbidities, and mortality in PEH in Santiago, Chile.
Materials and MethodsWe conducted a retrospective cohort study using registry data from the Salud Calle Foundation between 2010 and 2019. Sociodemographic variables, alcohol use, comorbidities, and mortality were analyzed.
ResultsA total of 751 individuals were included (21.1% women; median age 48.1 ± 16.9 years). The median duration of homelessness was 76.3 months. Active alcohol use was reported by 55.7%, with 74.6% classified as heavy drinkers (mean daily intake: 218 g). Comorbidities included hypertension (23.6%), type 2 diabetes (12%), and dyslipidemia (10.5%). Compared to women, men were older (49.2 vs. 44.1 years, p<0.001) and more likely to use alcohol (62.6% vs. 30.4%, p<0.001). Over 10 years, 21.8% died, mainly from infections (31.2%) and decompensated cirrhosis (10.1%). Among those with cirrhosis, 46.8% died on the street or in shelters, with a median age at death of 61 years. Overall survival was 95.7% at 1 year, 88.9% at 3 years, and 85% at 5 years. Older age (sHR 1.05) and male sex (sHR 2.89) were independently associated with mortality in the cohort.
ConclusionsPEH in Chile face substantial liver-related and overall mortality, driven by alcohol use, chronic disease, and poor access to care. Tailored public health interventions addressing substance use and gender-specific needs are urgently needed.
