Premium
Factors Influencing the Prognosis of the Alcoholic Patient with Cirrhosis
Author(s) -
Rankin James R.,
Wilkinson Patricia,
Santamaria Joseph N.
Publication year - 1970
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1970.19.3.232
Subject(s) - medicine , cirrhosis , alcoholic liver disease , ascites , varices , marital status , hepatic encephalopathy , jaundice , pediatrics , surgery , population , environmental health
Summary Seventy seven alcoholic patients, 54 men and 23 women were found to have cirrhosis of the liver when they first attended the Alcoholism Clinic at St. Vincent's Hospital, Melbourne, between July 1964, and June 1968. Seven of these patients were in the terminal phase of their illness and died without leaving hospital. Fourteen patients attended the clinic only briefly and could not be traced subsequently. The remaining 56 alcoholic patients, 40 men and 16 women with histologically proven cirrhosis were followed for periods of from ten to 57 months (mean 31 months). Mortality and morbidity from complications of cirrhosis were correlated with the patients' drinking habits during the period of study, their occupational status and their sex. Fourteen patients gave up alcohol completely, 17 reduced their alcohol intake, while 25 did not modify their drinking habits. The periods of follow‐up were similar in these three groups and also in men compared with women, and in men of “white‐collar” occupational status compared with “blue‐collar” male workers. The most important factor influencing the clinical course of cirrhosis in this series of patients was the continued consumption of alcoholic beverages. All but one of the 14 patients who stopped drinking were alive at the end of the study, and had been symptomfree from the time of initial therapy. Eight of the 42 patients who continued to drink had died, and 23 had experienced episodes of jaundice, hepatic encephalopathy, ascites or haemorrhage from oesophageal varices. Social class also appeared to influence the outcome of established alcoholic cirrhosis. “Blue‐collar” workers presented more often with symptomatic cirrhosis, and subsequently experienced greater morbidity and mortality. Morbidity and mortality were not significantly different in men and women with alcoholic cirrhosis. These results suggest that in the patient with alcoholic cirrhosis, where the prognosis for the underlying alcoholism is good, the outlook for cirrhosis is also favourable and vigorous treatment of both conditions is indicated.