Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study.

• Published in: Scandinavian Journal of Gastroenterology
• Main Authors: Björnsson, Einar S, Hauksson, Kristjan, Sigurdardottir, Ragna, Arnardottir, Margret, Agustsson, Arnar S, Lund, Sigrun H, Kalaitzakis, Evangelos
• Other Authors: 1Faculty of Medicine, University of Iceland, Reykjavík, Iceland. 2Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland. 3Digestive Disease Center, Copenhagen University Hospital/Herlev, University of Copenhagen, Copenhagen, Denmark. 4Department of Gastroenterology, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis 2020
• Subjects: Hepatitis; hepatocellular carcinoma; hepatology; liver; liver cirrhosis; Alkóhól; Áfengisvarnir; Liver Diseases; Alcoholic; Alcohol Abstinence; Iceland
• Online Access: http://hdl.handle.net/2336/621373; https://doi.org/10.1080/00365521.2020.1743751

To access publisher's full text version of this article click on the hyperlink below 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.