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Short-term and long-term causes of death in patients with alcoholic hepatitis in Denmark.
Clin Gastroenterol Hepatol. 2014 Oct; 12(10):1739-44.e1.CG

Abstract

BACKGROUND & AIMS

The incidence of acute alcoholic hepatitis is increasing, and mortality is high. However, causes of death among patients with alcoholic hepatitis have not been systematically recorded. We investigated causes of death in a population-based cohort of patients with alcoholic hepatitis who were followed for as long as 10 years.

METHODS

We used the Danish National Registry of Patients to identify all patients with a first-time episode of alcoholic hepatitis from 1999 through 2008. We collected and analyzed data on 1951 patients, identifying causes of death, diagnoses of cirrhosis, and alcohol abuse.

RESULTS

Of the 1951 patients, 401 died within the first 84 days after admission, and 600 died later (through December 31, 2008). Most deaths within the first 84 days after admission resulted from liver failure (40%), infections (20%), or hepatorenal syndrome (11%). Beyond 84 days, causes of deaths differed between patients with and without cirrhosis; most patients without cirrhosis (n = 326) died of causes related to alcohol abuse, whereas most patients with cirrhosis (n = 675) died of liver failure (34%), infections (16%), or variceal bleeding (11%). Cirrhosis was present in 51% of patients diagnosed with alcoholic hepatitis. Among patients without cirrhosis, 24% developed cirrhosis within 10 years; continued alcohol abuse was a strong risk factor for cirrhosis (hazard ratio, 2.14; 95% confidence interval, 1.50-3.05). The 10-year risk of a second episode of alcoholic hepatitis was 12%.

CONCLUSIONS

On the basis of a study of the Danish population, the most common causes of death among patients with alcoholic hepatitis, within 84 days and within 10 years, are liver-related events and infections. Strategies are to identify and treat these complications and to reduce alcoholism.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Orntoft NW
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: nikolaj.oerntoft@aarhus.rm.dk.
Sandahl TD
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Jepsen P
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Vilstrup H
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

MeSH

Cause of DeathCohort StudiesCommunicable DiseasesDenmarkFemaleHepatitis, AlcoholicHumansLiver FailureMaleMiddle Aged

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24780287

Citation

Orntoft, Nikolaj Worm, et al. "Short-term and Long-term Causes of Death in Patients With Alcoholic Hepatitis in Denmark." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 12, no. 10, 2014, pp. 1739-44.e1.
Orntoft NW, Sandahl TD, Jepsen P, et al. Short-term and long-term causes of death in patients with alcoholic hepatitis in Denmark. Clin Gastroenterol Hepatol. 2014;12(10):1739-44.e1.
Orntoft, N. W., Sandahl, T. D., Jepsen, P., & Vilstrup, H. (2014). Short-term and long-term causes of death in patients with alcoholic hepatitis in Denmark. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 12(10), 1739-e1. https://doi.org/10.1016/j.cgh.2014.04.020
Orntoft NW, et al. Short-term and Long-term Causes of Death in Patients With Alcoholic Hepatitis in Denmark. Clin Gastroenterol Hepatol. 2014;12(10):1739-44.e1. PubMed PMID: 24780287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term and long-term causes of death in patients with alcoholic hepatitis in Denmark. AU - Orntoft,Nikolaj Worm, AU - Sandahl,Thomas Damgaard, AU - Jepsen,Peter, AU - Vilstrup,Hendrik, Y1 - 2014/04/26/ PY - 2013/12/08/received PY - 2014/03/13/revised PY - 2014/04/07/accepted PY - 2014/5/1/entrez PY - 2014/5/2/pubmed PY - 2015/5/28/medline KW - Alcohol-Associated Hepatitis KW - Alcoholic Liver Disease KW - Epidemiology KW - Variceal Hemorrhage SP - 1739 EP - 44.e1 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin Gastroenterol Hepatol VL - 12 IS - 10 N2 - BACKGROUND & AIMS: The incidence of acute alcoholic hepatitis is increasing, and mortality is high. However, causes of death among patients with alcoholic hepatitis have not been systematically recorded. We investigated causes of death in a population-based cohort of patients with alcoholic hepatitis who were followed for as long as 10 years. METHODS: We used the Danish National Registry of Patients to identify all patients with a first-time episode of alcoholic hepatitis from 1999 through 2008. We collected and analyzed data on 1951 patients, identifying causes of death, diagnoses of cirrhosis, and alcohol abuse. RESULTS: Of the 1951 patients, 401 died within the first 84 days after admission, and 600 died later (through December 31, 2008). Most deaths within the first 84 days after admission resulted from liver failure (40%), infections (20%), or hepatorenal syndrome (11%). Beyond 84 days, causes of deaths differed between patients with and without cirrhosis; most patients without cirrhosis (n = 326) died of causes related to alcohol abuse, whereas most patients with cirrhosis (n = 675) died of liver failure (34%), infections (16%), or variceal bleeding (11%). Cirrhosis was present in 51% of patients diagnosed with alcoholic hepatitis. Among patients without cirrhosis, 24% developed cirrhosis within 10 years; continued alcohol abuse was a strong risk factor for cirrhosis (hazard ratio, 2.14; 95% confidence interval, 1.50-3.05). The 10-year risk of a second episode of alcoholic hepatitis was 12%. CONCLUSIONS: On the basis of a study of the Danish population, the most common causes of death among patients with alcoholic hepatitis, within 84 days and within 10 years, are liver-related events and infections. Strategies are to identify and treat these complications and to reduce alcoholism. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/24780287/Short_term_and_long_term_causes_of_death_in_patients_with_alcoholic_hepatitis_in_Denmark_ DB - PRIME DP - Unbound Medicine ER -