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Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study.
Scand J Gastroenterol. 2020 Apr; 55(4):472-478.SJ

Abstract

Objective: Abstinence from alcohol is recommended in patients diagnosed with alcoholic hepatitis (AH) and alcoholic cirrhosis (AC). We aimed to determine the impact of alcohol abstinence on prognosis of patients with AC and AH.Methods: All incident AC and AH patients in Iceland 2001-2016 were identified. Cirrhosis was confirmed clinically, biochemically, with imaging and histologically. Abstinence, alcohol rehabilitation and survival were analyzed.Results: Overall, 169 patients with AC and/or AH were identified. Eleven died during index hospitalization, leaving 158 patients for final analysis, median (IQR) age 56 years (48-65), 72% males. Over all 61 patients (39%) had AC, 40 (25%) AH and 57 (36%) features of both. Thirty-nine percent of patients remained abstinent during follow-up and 63% underwent alcohol rehabilitation. Moderate to severe ascites at diagnosis (odds ratio (OR): 3.05, 95% confidence interval (CI): 1.37-7.02) and lack of alcoholic rehabilitation (OR: 5.28, 95% CI: 2.24- 14.11) were independent predictors of abstinence. Abstinence at one year of follow-up was not related to increased survival. Patients surviving one year, abstinence during follow-up was related to increased survival for both groups.Conclusion: Abstinence from alcohol following AC/AH diagnosis was achieved in 39% of patients. Abstinence was not related to increased survival for alcoholic liver disease patients at one-year, which might partly indicate that this might be a marker that some patients were 'too sick to drink'. AC and AH patients who survived one year and remained abstinent had a favorable long-term prognosis.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Björnsson ES
Faculty of Medicine, University of Iceland, Reykjavík, Iceland. Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland.
Hauksson K
Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland.
Sigurdardottir R
Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
Arnardottir M
Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland.
Agustsson AS
Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland.
Lund SH
Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
Kalaitzakis E
Digestive Disease Center, Copenhagen University Hospital/Herlev, University of Copenhagen, Copenhagen, Denmark. Department of Gastroenterology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.

MeSH

AgedAlcohol AbstinenceFemaleHepatitis, AlcoholicHumansIcelandLiver Cirrhosis, AlcoholicMaleMiddle AgedPrognosisRetrospective StudiesSurvival AnalysisTime Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32233877

Citation

Björnsson, Einar S., et al. "Abstinence From Alcohol and Alcohol Rehabilitation Therapy in Alcoholic Liver Disease: a Population-based Study." Scandinavian Journal of Gastroenterology, vol. 55, no. 4, 2020, pp. 472-478.
Björnsson ES, Hauksson K, Sigurdardottir R, et al. Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study. Scand J Gastroenterol. 2020;55(4):472-478.
Björnsson, E. S., Hauksson, K., Sigurdardottir, R., Arnardottir, M., Agustsson, A. S., Lund, S. H., & Kalaitzakis, E. (2020). Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study. Scandinavian Journal of Gastroenterology, 55(4), 472-478. https://doi.org/10.1080/00365521.2020.1743751
Björnsson ES, et al. Abstinence From Alcohol and Alcohol Rehabilitation Therapy in Alcoholic Liver Disease: a Population-based Study. Scand J Gastroenterol. 2020;55(4):472-478. PubMed PMID: 32233877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study. AU - Björnsson,Einar S, AU - Hauksson,Kristjan, AU - Sigurdardottir,Ragna, AU - Arnardottir,Margret, AU - Agustsson,Arnar S, AU - Lund,Sigrun H, AU - Kalaitzakis,Evangelos, Y1 - 2020/04/01/ PY - 2020/4/3/pubmed PY - 2021/3/13/medline PY - 2020/4/3/entrez KW - Hepatitis KW - hepatocellular carcinoma KW - hepatology KW - liver KW - liver cirrhosis SP - 472 EP - 478 JF - Scandinavian journal of gastroenterology JO - Scand J Gastroenterol VL - 55 IS - 4 N2 - Objective: Abstinence from alcohol is recommended in patients diagnosed with alcoholic hepatitis (AH) and alcoholic cirrhosis (AC). We aimed to determine the impact of alcohol abstinence on prognosis of patients with AC and AH.Methods: All incident AC and AH patients in Iceland 2001-2016 were identified. Cirrhosis was confirmed clinically, biochemically, with imaging and histologically. Abstinence, alcohol rehabilitation and survival were analyzed.Results: Overall, 169 patients with AC and/or AH were identified. Eleven died during index hospitalization, leaving 158 patients for final analysis, median (IQR) age 56 years (48-65), 72% males. Over all 61 patients (39%) had AC, 40 (25%) AH and 57 (36%) features of both. Thirty-nine percent of patients remained abstinent during follow-up and 63% underwent alcohol rehabilitation. Moderate to severe ascites at diagnosis (odds ratio (OR): 3.05, 95% confidence interval (CI): 1.37-7.02) and lack of alcoholic rehabilitation (OR: 5.28, 95% CI: 2.24- 14.11) were independent predictors of abstinence. Abstinence at one year of follow-up was not related to increased survival. Patients surviving one year, abstinence during follow-up was related to increased survival for both groups.Conclusion: Abstinence from alcohol following AC/AH diagnosis was achieved in 39% of patients. Abstinence was not related to increased survival for alcoholic liver disease patients at one-year, which might partly indicate that this might be a marker that some patients were 'too sick to drink'. AC and AH patients who survived one year and remained abstinent had a favorable long-term prognosis. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/32233877/Abstinence_from_alcohol_and_alcohol_rehabilitation_therapy_in_alcoholic_liver_disease:_a_population_based_study_ DB - PRIME DP - Unbound Medicine ER -