Alloveda Liver Update: Clinical Presentation and Determinants of Mortality of Alcohol-Related Liver Disease |
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Alloveda Liver Update: Clinical Presentation and Determinants of Mortality of Alcohol-Related Liver Disease

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There has been an alarming rise in the incidence of alcohol-related liver disease in India. Characterizing the factors that affect mortality is required in order to have optimal utilization of the available resources, such as liver transplantation.

A study was conducted that compared the baseline data of 395 patients with alcohol-related liver disease - age; clinical presentation; alcohol parameters in terms of amount, duration, type; laboratory parameters to determine organ failure; and prognostic scores - between survivors and the deceased. A subgroup analysis was conducted among the deceased group to determine the factors associated with early mortality in acute-on-chronic liver failure (ACLF) and cirrhosis patients. All patients received only best supportive medical therapy.

Nearly 20.3% of the patients had alcoholic hepatitis (without cirrhosis) and had complete recovery with abstinence. In all, 79.7% either had cirrhosis (46.1%) or ACLF (33.6%) at presentation; all passed away within the next 2 years of follow-up, which was earlier in the ACLF cases. It was noted that all the deceased patients had been heavy drinkers for long periods of time (>85 g/day for over 17 years). Higher age, amount of alcohol consumed, number of organ failures and discriminant function score appeared to predict severe disease and early mortality, with the latter being the best predictor.

 

The European Foundation for the study of chronic liver failure consortium (CLIF-C) score is applicable well in Indian ACLF cohorts. Serum glutamic pyruvic transaminase level was shown to be normal in 73.8% of deceased patients compared to 12.5% of the survivor group. Abstinence did not bring about complete normalization of deranged laboratory parameters in the deceased.

 

Alcohol-related liver disease is a serious condition and is associated with high short-term mortality. There is a need to introduce urgent measures to limit this rising problem.

Source: Ray G, Manjubhargav P. Clinical Presentation and Mortality Determinants of Alcohol-Related Liver Disease: A Single-Center Experience of the Rising Menace from Eastern India. Inflamm Intest Dis. 2019 Aug;4(3):104-114.

 

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