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Five‐year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence
Author(s) -
Pessione F.,
Ramond MJ.,
Peters L.,
Pham BN.,
Batel P.,
Rueff B.,
Valla DC.
Publication year - 2003
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1034/j.1600-0676.2003.01804.x
Subject(s) - medicine , cirrhosis , alcoholic liver disease , gastroenterology , alcoholic hepatitis , concomitant , abstinence , liver disease , alcohol , psychiatry , biochemistry , chemistry
Aim: To evaluate 5‐year survival predictive factors in hospitalised patients with excessive alcohol intake and cirrhosis, including in a multivariate analysis the severity of the liver disease, gastrointestinal bleeding, concomitant viral B or C infection, smoking status, presence of alcoholic hepatitis at inclusion and abstinence from alcohol during follow‐up. Methods: In a non‐concurrent cohort study, 122 patients with excessive alcohol intake and cirrhosis were followed up at least five years or till death. Two patients were lost to follow‐up. Results: The 5‐year survival rates were 43% in the 122 patients and 66%, 50% and 25% in Child–Pugh class A, B and C patients, respectively. In multivariate analysis, age ( P = 0.01), Child–Pugh score ( P = 0.0001), gastrointestinal bleeding ( P = 0.01), presence of HBs Ag and/or anti‐HCV ( P = 0.03), smoking ( P = 0.01), absence of histologically proven alcoholic hepatitis ( P = 0.05) and persistent alcohol intake ( P = 0.002) were associated with significantly increased risk ratios of death. Conclusions: In hospitalised patients with excessive alcohol intake and cirrhosis: (1) age, liver failure, gastrointestinal bleeding, concomitant viral B or C infection and persistent alcohol intake are independent poor prognostic markers, (2) smoking may contribute to the aggravation of cirrhosis, and (3) alcoholic hepatitis, being a potentially reversible cause of liver failure, has a favourable prognostic significance.