Alcohol intake tied to poor survival in patients with alcohol-related cirrhosis

People with alcohol-related compensated cirrhosis must quit drinking any alcoholic beverage entirely if they want to live longer, a recent study suggests.

A total of 650 patients (median age at baseline 58.4 years, 67.4 percent men, median body mass index 27.8 kg/m²) were enrolled in this study from 2010 to 2016. Of these, 63.8 percent had a history of liver decompensation, and 70.2 percent had stopped drinking alcohol.

Recurrence at 5 years occurred in 30.9 percent of abstinent patients. This risk was higher in those with a history of drug abuse and those with shorter alcohol discontinuation times.

Median survival was 97 months. Multivariate analysis revealed the following factors to be associated with overall and liver event-free survival: age, alcohol consumption at baseline, platelet count, and Child-Pugh score >5.

During follow-up, alcohol intake of >25 glass-years independently correlated with lower survival and trended toward lower liver event-free survival, with the risk increasing from 1 glass-year albeit nonsignificantly.

“Simon & Makuch plots confirm the benefit of no alcohol consumption (<1 glass/week) on both outcomes and the dose-dependent impact of alcohol over time,” the authors said.

In this study, patients with biopsy-proven compensated alcohol-related cirrhosis from the CIRRAL cohort (22 centres) were prospectively analysed. The authors used multivariable Cox models with stepwise selection to assess the prognostic variables of survival and liver event-free survival.

In addition, a time-dependent covariable was used to examine the prognostic impact of alcohol recurrence during follow-up (computed in glass-years in the same way as pack-year for tobacco).