Characteristics of alcoholic liver disease and predictive factors for mortality of patients with alcoholic cirrhosis

• Published in: Hepatobiliary & pancreatic diseases international 2013-12, Vol.12 (6), p.594-601
• Main Authors: Xie, Yan-Di, Feng, Bo, Gao, Yan, Wei, Lai
• Format: Article
• Language: English
• Subjects: Adult; Alcohol Drinking; alcoholic; alcoholic liver disease; disease; end-stage; Endocrinology & Metabolism; factors; Female; for; Gastroenterology and Hepatology; Humans; liver; Liver - enzymology; Liver Cirrhosis, Alcoholic - epidemiology; Liver Cirrhosis, Alcoholic - mortality; Liver Diseases, Alcoholic - complications; Liver Diseases, Alcoholic - diagnosis; Liver Diseases, Alcoholic - metabolism; Male; Middle Aged; model for end-stage liver disease; Models, Biological; mortality; Multivariate Analysis; Predictive Value of Tests; Prognosis; prognostic; prognostic factors; Retrospective Studies; risk; Risk Factors; Survival Rate; Time Factors
• ISSN: 1499-3872
• DOI: 10.1016/S1499-3872(13)60094-6

BACKGROUND:Alcoholic liver disease is one of the major chronic liver diseases worldwide.The aim of the study was to describe the clinical characteristics of alcoholic liver disease and to compare the predictive values of biochemical parameters,complications,Child-Turcotte-Pugh score,model for end-stage liver disease(MELD)score and discriminant function score for the mortality of in-hospital or 3-month after discharge of patients with alcoholic cirrhosis(AC).METHODS:A retrospective record review and statistical analysis were performed on 205 consecutive patients with the discharge diagnosis of alcoholic liver disease.Three models were used to predict the mortality of patients with AC.The number of variceal hemorrhage,infection,hepatic encephalopathy and hepatocellular carcinoma was analyzed as"numbers of complications".Model 1 consisted of creatinine,white blood cell count,international normalized ratio and"numbers of complications".Model 2 consisted of MELD score.Model 3included"numbers of complications"and MELD score.RESULTS:The risk of developing AC was significant for patients with alcohol consumption of higher than 80 g/d(OR=2.807,P<0.050)and drinking duration of longer than 10 years(OR=3.429,P<0.028).The area under curve for predicting inhospital mortality of models 1,2 and 3 was 0.950,0.886 and 0.911(all P<0.001),respectively.The area under curve for predicting the 3-month mortality of models 1,2 and 3 was 0.867,0.878 and0.893(all P<0.001),respectively.CONCLUSIONS:There is a dose-dependent relationship between alcohol consumption and the risk of developing AC.MELD score has a better predictive value than Child-TurcottePugh or discriminant function score for patients with AC,and model 1 or 3 is better than model 2.