The alcoholic liver disease ranges from the initial fatty change through an intermediate stage of alcoholic hepatitis to alcoholic cirrhosis. Its evolution is directly associated with an increased mortality rate combining the presence of liver disease and the other complications of alcohol abuse. Fatty liver is however a benign lesion that reverses completely in most of the patients following abstinence from alcohol. 

Continued drinking leads to the development of cirrhosis in nearly 20% of individuals. 2 years and at 10 years survival rates are reported to be 70% in both cases. 

Alcoholic hepatitis, which is a pre-cirrhotic lesion, progresses to cirrhosis. It is predominant in women, individuals with severe disease and those who continue to drink. Patients with mild to moderate disease show 30 mortality rates of <20% while it exceeds to 40% in individuals with severe liver injury. Short term survival in a small subgroup of patients with severe alcoholic hepatitis can be improved with Corticosteroids. 2 years and at 10 years survival rates are reported to be 55 to 60% in both cases. Factors like female gender, the elderly, individuals adversely affected by the presence of severe liver injury, evolution to cirrhosis and continuation of drinking reduces the survival rate. 

The decompensated disease is present in nearly Two-thirds of patients with alcoholic cirrhosis; 15% of which will progress to hepatocellular carcinoma. 5 years Survival rates vary from zero to 80%, in which 60 to 90% of individuals’ die of their liver disease. The presence of decompensated disease, superimposed alcoholic hepatitis, continued drinking and the development of hepatocellular carcinoma further reduces the Survival rate. 

Hepatic transplantation, which shows a 5-year survival rate of nearly 70%, will further influence these survival figures.

Source: Morgan MY. The prognosis and outcome of alcoholic liver disease. Alcohol Alcohol Suppl. 1994;2:335-43. PMID: 8974353.