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News

Alcohol abstinence in patients surviving an episode of alcoholic hepatitis

December's Hepatology identified predictors of alcohol abstinence in patients surviving an episode of alcoholic hepatitis.

News image

Alcoholic hepatitis is the most severe form of alcoholic liver disease.

Most studies have focused on short-term prognosis, whereas factors associated with long-term survival are largely unknown.

Dr José Altamirano and colleagues from Spain determined the impact of complete abstinence from alcohol on long-term survival, and identified prognostic factors at admission capable of predicting abstinence during long-term follow-up in patients with alcoholic hepatitis.

The team evaluated 142 patients with biopsy-proven alcoholic hepatitis that survived the first episode were included.

Demographic, psychiatric, and biochemical variables at admission and drinking status during follow-up were obtained.

The research team observed that overall mortality was 38% with a median follow-up of 55 months.

Overall mortality was 38% with a median follow-up of 55 months
Hepatology

During follow-up, complete abstinence was reported in 39% and was associated with better long-term survival.

After adjustment for baseline prognostic scoring systems, complete abstinence was independently associated with survival.

The team noted that age and lack of past alcoholism treatments were independently associated with complete abstinence during follow-up.

CART analysis generated a simple and practical algorithm based on the combination of past alcoholism treatments and age.

Using CART analysis, the research team stratified 2 subgroups of patients with high, and low rates of complete abstinence after an episode of alcoholic hepatitis.

Dr Altamirano's team concludes, "Complete abstinence after an episode of alcoholic hepatitis positively impacts long-term survival."

"The combination of 2 variables easily obtained at admission might be useful to predict long-term abstinence after an episode of alcoholic hepatitis."

"Strategies aimed at promoting alcohol abstinence in these patients are necessary."

Hepatology 2017: 66(6): 1842–1853
19 December 2017

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