2018, Number 3
<< Back Next >>
Ann Hepatol 2018; 17 (3)
Alcohol Consumption Influences Clinical Outcome in Patients Admitted to a Referral Center for Liver Disease
dos Santos SGR, Mattos AA, Guimarães MM, Boger BS, Coral GP
Language: English
References: 50
Page: 470-475
PDF size: 139.75 Kb.
ABSTRACT
Introduction and aim. Excessive alcohol consumption is a public health concern worldwide and has been associated with high
mortality rates. This study aimed to determine the prevalence of alcohol consumption and its influence on the prognosis of hospitalized
cirrhotic patients in a tertiary care hospital.
Material and methods. We reviewed the medical records of all patients with hepatic
cirrhosis admitted between January 2009 and December 2014, in a referral center for liver disease in southern Brazil. Data on
clinical outcomes, associated conditions, infections, and mortality were collected and compared between alcoholic and nonalcoholic
patients.
Results. The sample consisted of 388 patients; 259 (66.7%) were men. One hundred fifty-two (39.2%) were classified as
heavy use of alcohol. Most alcoholic patients were men (n = 144; 94.7%). Mean age was 55.6 ± 8.9 years. Hepatic decompensations
and infections were more prevalent in alcoholic patient. Spontaneous bacterial peritonitis and respiratory tract infection accounted
for most of the infections. Excessive alcohol consumption was associated with mortality (P = 0.009) in multivariate analysis.
Conclusion. On the present study, the prevalence of heavy use of alcohol was high and associated with a poorer prognosis in hospitalized
cirrhotic patients, increasing the risk of infection and death.
REFERENCES
Gowing LR, Ali RL, Allsop S, Marsden J, Turff EE, West R, Witton J. Global statistics on addictive behaviours: 2014 status report. Addiction 2015; 100: 904-19.
Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Prevalence of alcohol dependence among US adult drinkers, 2009-2011. Prev Chronic Dis 2014; 11: 1-11.
Damacena GN, Malta DC, Boccolini CS, Souza PR Junior, Almeida WD, Ribeiro LS, Szwarcwald CL. Alcohol abuse and involvement in traffic accidents in the Brazilian population, 2013. Cien Saude Colet 2016; 21: 3777-86.
Han KH, Hashimoto N, Fukushima M. Relationships among alcoholic liver disease, antioxidants, and antioxidant enzymes. World J Gastroenterol 2016; 22: 37-49.
Louvet A, Mathurin P. Alcoholic liver disease: mechanisms of injury and targeted treatment. Nat Rev Gastroenterol Hepatol 2015; 12: 231-42.
Gao B, Bataller R. Alcoholic liver disease: pathogenesis and new therapeutic targets. Gastroenterology 2011; 141: 1572- 85.
Louvet A. Restoration of bactericidal activity of neutrophils by myeloperoxidase release: A new perspective for preventing infection in alcoholic cirrhosis. J Hepatol 2016; 64: 1006-7.
Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, Laleman W, et al. Clinical Course of acute-onchronic liver failure syndrome and effects on prognosis. Hepatology 2015; 62: 243-52.
Moreau R, Jalan R, Gines P, Pavesi M, Angeli P, Cordoba J, Durand F, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 2013; 144: 1426-37.
Kim WR, Brown RS Jr., Terrault NA, El-Serag H. Burden of liver disease in the United States: summary of a workshop. Hepatology 2002; 36: 227-42.
Abenavoli L, Milic N, Rouabhia S, Addolorato G. Pharmacotherapy of acute alcoholic hepatitis in clinical practice. World J Gastroenterol 2014; 20: 2159-67.
Paula H, Asrani SK, Boetticher NC, Pedersen R, Shah VH, Kim WR. Alcoholic liver disease-related mortality in the United States: 1980-2003. Am J Gastroenterol 2010; 105: 1782-7.
Nader LA, Mattos AAD, Bastos GA. Burden of liver disease in Brazil. Liver Int 2014; 34: 844-9.
European Association for the Study of the Liver. EASL clinical practical guidelines: management of alcoholic liver disease. J Hepatol 2012; 57: 399-420.
Vitor S, Marinho RT, Giria J, Velosa J. An observational study of the direct costs related to hospital admissions, mortality and premature death associated with liver disease in Portugal. BMC Res Notes 2016; 9: 62.
Gawryszewski VP, Monteiro MG. Mortality from diseases, conditions and injuries where alcohol is a necessary cause in the Americas, 2007-09. Addiction 2014; 109: 570-7.
Roson B, Monte R, Gamallo R, Puerta R, Zapatero A, Fernández- Solá J, Pastor I, et al. Prevalence and routine assessment of unhealthy alcohol use in hospitalized patients. Eur J Intern Med 2010; 21: 458-64.
Park JK, Lee CH, Kim IH, Kim SM, Jang JW, Kim SH, Kim SW, et al. Clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease. J Korean Med Sci 2015; 30: 598-605.
Otete HE, Orton E, Fleming KM, West J. Alcohol-attributable healthcare attendances up to 10 years prior to diagnosis of alcoholic cirrhosis: a population based case-control study. Liver Int 2016; 36: 538-46.
Gradus JL, Leatherman S, Curreri A, Myers LG, Ferquson R, Miller M. Gender differences in substance abuse, PTSD and intentional self-harm among veterans health administration patients. Drug Alcohol Depend 2017; 171: 66-9.
Tandra S, Forssell K, Vuppalanchi R, Burton JR, Jr., Nguyen J, Mullis D, et al. Incidence and predictors of 30-day readmission among patients hospitalized for advanced liver disease. Clin Gastroenterol Hepatol 2011; 9: 254-9.
Gonçalves CS, Gomes MPZ, Gonçalves PL, Gonçalves LL, Pereira FEL. Alcoholic hepatitis. J Bras Gastroenterol 2006; 6: 59-68.
Rehm J, Taylor B, Mohapatra S, Irving H, Baliunas D, Patra J, Roerecke M. Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev 2010; 29: 437-45.
Rivas I, Sanvisens A, Bolao F, Fuster D, Tor J, Pujol R, Torrens M, et al. Impact of medical comorbidity and risk of death in 680 patients with alcohol use disorders. Alcohol Clin Exp Res 2013; 37(Suppl. 1): E221-7.
Torok NJ. Update on Alcoholic Hepatitis. Biomolecules 2015; 5: 2978-86.
Lucey MR, Mathurin P, Morgan TR. Alcoholic hepatitis. N Engl J Med 2009; 360: 2758-69.
Altamirano J, Higuera-de laTijera F, Duarte-Rojo A, Martínez- Vázquez MA, Abraldes JG, Herrera-Jiménez LE, Michelena J, et al. The amount of alcohol consumption negatively impacts short-term mortality in Mexican patients with alcoholic hepatitis. Am J Gastroenterol 2011; 106: 1472-80.
Singal AK, Anand BS. Recent trends in the epidemiology of alcoholic liver disease. Clin Liver Dis 2013; 2: 53-6.
Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B, Valla DC. Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence. Liver Int 2003; 23: 45-53.
Yoshita K, Miura K, Morikawa Y, Ishizaki M, Kido T, Naruse Y, Soyama Y, et al. Relationship of alcohol consumption to 7- year blood pressure change in Japanese men. J Hypertens 2005; 23: 1485-90.
Fuster D, Sanvisens A, Bolao F, Zuluaga P, Rivas I, Tor J, Muga R. Markers of inflammation and mortality in a cohort of patients with alcohol dependence. Medicine (Baltimore) 2015; 94(10): e607.
Tsui JI, Pletcher MJ, Vittinghoff E, Seal K, Gonzales R. Hepatitis C and hospital outcomes in patients admitted with alcohol- related problems. J Hepatol 2006; 44: 262-6.
Novo-Veleiro I, Calle Cde L, Dominguez-Quiben S, Pastor I, Marcos M, Laso FJ. Prevalence of hepatitis C virus infection in alcoholic patients: cohort study and systematic review. Alcohol Alcohol 2013; 48: 564-9.
Novo-Veleiro I, Alvela-Suarez L, Chamorro AJ, Gonzalez- Sarmiento R, Laso FJ, Marcos M. Alcoholic liver disease and hepatitis C virus infection. World J Gastroenterol 2016; 22: 1411-20.
Averhoff FM, Glass N, Holtzman D. Global burden of hepatitis C: considerations for healthcare providers in the United States. Clin Infect Dis 2012; 55 (Suppl. 1): S10-5.
Pereira LM, Martelli CM, Moreira RC, Merchan-Hamman E, Stein AT, Cardoso MR, Figueiredo GM, et al. Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study. BMC Infect Dis 2013; 13: 60.
Gitto S, Vitale G, Villa E, Andreone P. Update on Alcohol and Viral Hepatitis. J Clin Transl Hepatol 2014; 2: 228-33.
Mathurin P, Bataller R. Trends in the management and burden of alcoholic liver disease. J Hepatol 2015; 62: S38-46.
Askgaard G, Gronbaek M, Kjaer MS, Tjonneland A, Tolstrup JS. Alcohol drinking pattern and risk of alcoholic liver cirrhosis: a prospective cohort study. J Hepatol 2015; 62: 1061-7.
Morrison D, Sgrillo J, Daniels LH. Managing alcoholic liver disease. Nursing 2014; 44: 30-40.
Ripoll C, Groszmann R, Garcia-Tsao G, Grace N, Burroughs A, Planas R, Escorsell A, et al. Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Gastroenterology 2007; 133: 481-8.
Jepsen P, Ott P, Andersen PK, Sorensen HT, Vilstrup H. Clinical course of alcoholic liver cirrhosis: a Danish population- based cohort study. Hepatology 2010; 51: 1675-82.
El-Serag HB. Hepatocellular carcinoma. N Engl J Med 2011; 365: 1118-27.
Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology 2004; 127: S35-50.
Singal AG, El-Serag HB. Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice. Clin Gastroenterol Hepatol 2015; 13: 2140-51.
Mancebo A, González-Diéguez ML, Cadahía V, Varela M, Pérez R, Navascués CA, Sotorríos NG, et al. Annual incidence of hepatocellular carcinoma among patients with alcoholic cirrhosis and identification of risk groups. Clin Gastroenterol Hepatol 2013; 11: 95-101.
Carrilho FJ, Kikuchi L, Branco F, Goncalves CS, Mattos AA. Clinical and epidemiological aspects of hepatocellular carcinoma in Brazil. Clinics (São Paulo) 2010; 65: 1285-90.
Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D. Bacterial infections in cirrhosis: A critical review and practical guidance. World J Hepatol 2016; 8: 307-21.
Mattos AA, Coral GP, Menti E, Valiatti F, Kramer C. Bacterial infection in cirrhotic patients. Arq Gastroenterol 2003; 40: 11-15.
Garcia LP, Freitas LRS, Gawryszewski VP, Duarte EC. Uso de álcool como causa necessária de morte no Brasil, 2010 a 2012. Rev Panam Salud Publica 2015; 38: 418-24.