Effect of alcohol consumption on diagnosis of liver cirrhosis patients’ survival at a University Hospital in Medellín

Authors

  • Diana Marcela Escobar Universidad de Antioquia
  • Juan Carlos Restrepo-Gutiérrez Universidad de Antioquia
  • Sergio Hoyos Universidad de Antioquia
  • María Cristina Navas Asociación Colombiana de Gastroenterología

DOI:

https://doi.org/10.22516/25007440.281

Keywords:

Cirrhosis, alcohol consumption, alcoholism, mortality, chronic liver disease

Abstract

Worldwide, alcohol consumption is a well-known risk factor for premature death, morbidity and disability. Records of mortality associated with alcohol consumption are not centralized. The aim of this study was to record the mortality rate associated with alcohol intake in patients with cirrhosis who were treated at a university hospital in the city of Medellin.

Materials and methods: We included 163 patients who had been diagnosed with cirrhosis in the outpatient hepatology clinic of a 277 bed referral hospital in Medellín. Patients were monitored until 2016. Sociodemographic, paraclinical and clinical variables were measured. Alcohol consumption was considered at the beginning of the follow-up. Survival and complications associated with cirrhosis were described and recorded for patients who consumed alcohol as well as for those who did not, and then the two groups were compared.

Results: One hundred sixty-three patients were followed until December 2016. The mortality rate among those who consumed alcohol was 51% while it was only 39% for those who did not consume alcohol (P = 0.19). Comparison of complications of cirrhosis showed that 68% of alcohol users developed ascites vs. 43% of non-consumers (P = 0.01); 40.6% of alcohol users developed encephalopathy vs. 13.5% of non-consumers (P = 0.00); and 29% of alcohol users developed hepatocellular carcinoma (HCC) vs. 17% of non-consumers (P = 0.08). In the subgroup analysis, patients with hepatitis C who consumed alcohol had a higher mortality rate than patients who did not consume alcohol (OR: 33, 95% CI: 1.06 to 1023).

Conclusions: Although alcohol consumption was not related to increased mortality among patients with cirrhosis in this study, increased mortality was observed in the subgroup of patients with hepatitis C.

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Author Biographies

Diana Marcela Escobar, Universidad de Antioquia

Grupo de gastrohepatología, facultad de medicina, Universidad de Antioquia. Hospital Pablo Tobón Uribe. Medellín, Colombia.

Juan Carlos Restrepo-Gutiérrez, Universidad de Antioquia

Grupo de gastrohepatología, facultad de medicina, Universidad de Antioquia. Hospital Pablo Tobón Uribe. Medellín, Colombia.

Sergio Hoyos, Universidad de Antioquia

Grupo de gastrohepatología, facultad de medicina, Universidad de Antioquia. Hospital Pablo Tobón Uribe. Medellín, Colombia.

María Cristina Navas, Asociación Colombiana de Gastroenterología

Grupo de gastrohepatología, facultad de medicina, Universidad de Antioquia. Medellín, Colombia.

References

Estrategia Nacional De Respuesta Integral Frente Al Consumo De Alcohol En Colombia. 2013;1–69. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/ENT/estrategia-nacional-alcohol-colombia.pdf

Roulot D, Costes JL, Buyck JF, Warzocha U, Gambier N, Czernichow S, et al. Transient elastography as a screening tool for liver fibrosis and cirrhosis in a community-based population aged over 45 years. Gut 2010;60:977–984.

https://doi.org/10.1136/gut.2010.221382

European Association For The Study Of The Liver. EASL clinical practical guidelines: management of alcoholic liver disease. Journal of Hepatology. 2012 Aug 31;57(2):399-420.

https://doi.org/10.1016/j.jhep.2012.04.004

Sheila Sherlock D. Alcoholic liver disease. Lancet. 1995;345(8944):227–9.

https://doi.org/10.1016/S0140-6736(95)90226-0

Yoon YH, Yi HY, Thomson PC. Liver cirrhosis mortality in the United States, 1970- 2009, surveillance Report #93. National Institute on Alcohol Abuse and Alcoholism; 2012.

Plunk AD, Syed-Mohammed H, Cavazos-Rehg P, Bierut LJ, Grucza RA. Alcohol Consumption, Heavy Drinking, and Mortality: Rethinking the J-Shaped Curve. Alcohol Clin Exp Res. 2014;38(2):471–8.

https://doi.org/10.1111/acer.12250

Dugum M, Mccullough A. Review Article Diagnosis and Management of Alcoholic Liver Disease. 2015;3:109–16.

Mathurin P, O'Grady J, Carithers RL, Phillips M, Louvet A, Mendenhall CL, et al. Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis: meta-analysis of individual patient data. Gut. 2011;60(2):255–60.

https://doi.org/10.1136/gut.2010.224097

Mathurin, P.; Moreno, C.; Samuel, D.; Dumortier, J.; Salleron, J.; Durand, F.; Castel, H.; Duhamel, A.; Pageaux, G.P.; Leroy, V.; Dharancy, S.; Louvet, A.; Boleslawski, E.; Lucidi, V.; Gustot, T.; Francoz, C.; Letoublon, C.; Castaing, D.; Belghiti, J.; Do JCE. Early Liver Transplantation for Severe Alcoholic Hepatitis. N Engl J Med. 2011;365:1790–800.

https://doi.org/10.1056/NEJMoa1105703

Bellentani S, Saccoccio G, Costa G, et al, Dionysus Study Group. Drinking habits as cofactors of risk for alcohol induced liver damage. Gut 1997;41:845–50.

https://doi.org/10.1136/gut.41.6.845

Chacko KR, Reinus J. Spectrum of alcoholic liver disease. Clinics in Liver Disease. 2016 Aug 31;20(3):419-27.

https://doi.org/10.1016/j.cld.2016.02.002

Saitz R. Unhealthy alcohol use. New England Journal of Medicine. 2005 Feb 10;352(6):596-607.

https://doi.org/10.1056/NEJMcp042262

Chan C, Levitsky J. Infection and Alcoholic Liver Disease. Clinics in Liver Disease. 2016 Aug 31;20(3):595-606.

https://doi.org/10.1016/j.cld.2016.02.014

Mandayam S, Jamal MM, Morgan TR. Epidemiology of alcoholic liver disease. Semin Liver Dis 2004;24:217-232.

https://doi.org/10.1055/s-2004-832936

Lieber CS, Jones DP, Decarli LM. Effects of prolonged ethanol intake: production of fatty liver despite adequate diets. J Clin Invest 1965;44: 1009-1021.

https://doi.org/10.1172/JCI105200

Albanis E, Friedman SL. Pathogenesis and Principles of Therapy. Curr Futur Treat Ther LIVER Dis. 2001;5(2):315–34.

Larkin J, Clayton MM, Liu J, et al. Chronic ethanol consumption stimulates hepa- titis B virus gene expression and replication in transgenic mice. Hepatology 2001; 34:792–7.

https://doi.org/10.1053/jhep.2001.27565

Westin J, Lagging LM, Spak F, et al. Moderate alcohol intake increases fibrosis progression in untreated patients with hepatitis C virus infection. J Viral Hepat 2002;9:235–41.

https://doi.org/10.1046/j.1365-2893.2002.00356.x

LinCW, Lin CC, Mo LR, et al. Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis. J Hepatol 2013; 58:730–5.

https://doi.org/10.1016/j.jhep.2012.11.045

Seitz H, StickeL F. Molecular mechanisms of alcohol-mediated carcinogenesis. Nat Rev Cancer. 2007;7(8):599.

https://doi.org/10.1038/nrc2191

Jee SH, Ohrr H, Sull JW, et al. Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea. J Natl Cancer Inst 2004;96: 1851–6.

https://doi.org/10.1093/jnci/djh334

Chan C, Levitsky J. Infection and Alcoholic Liver Disease. Clin Liver Dis 2016;20(3):595–606.

https://doi.org/10.1016/j.cld.2016.02.014

Suárez Quintero Y. Consumo de alcohol en Colombia:¿ sabemos en qué estamos?. Rev. colomb. gastroenterol. 2015 Dec 30;30(4):387-8.

Giraldo A, Barraza M, Villa H, Martínez J, García G. Caracterización epidemiológica de pacientes con cirrosis en una consulta de gastroenterologia en Pereira, Colombia, 2009-2012. Rev Med Risaralda. 2014;20(5):86–94.

Prieto O, Jhon E, Sánchez S, Prieto O, Robin G, Rojas D, Ever L, González L, Mendivelso F. Características clínicas y descompensación en pacientes con cirrosis hepática atendidos en dos centros de hepatología en la ciudad de Bogotá DC, 2010-2014. Revista Colombiana de Gastroenterología. 2016 Jan 1;31

Santos O, Londo-o M, Marín J, Mu-oz O, Mena A, Guzmán C, et al. Colombia Médica An experience of liver transplantation in Latin America : a medical center in Colombia. 2015;46:8–13.

Cortes-Mancera F, Loureiro CL, Hoyos S, Restrepo JC, Correa G, Jaramillo S, Norder H, Pujol FH, Navas MC. Etiology and viral genotype in patients with end-stage liver diseases admitted to a hepatology unit in Colombia. Hepat Res Treat 2011 Sep 20;2011.

Singal AK, Kamath PS, Gores GJ, Shah VH. Alcoholic hepatitis: current challenges and future directions. Clin Gastroenterol Hepatol [Internet]. 2014;12(4):555-64-2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23811249%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3883924

Chiva-Blanch G, Arranz S, Lamuela-Raventos RM ER. Effects of wine, alcohol and polyphenols on cardiovascular disease risk factors: evidences from human studies. Alcohol Alcohol. 1;48(3):27.

Sogabe M, Okahisa T, Taniguchi T, Tomonari T, Tanaka T, Tanaka H, Nakasono M TT. Light alcohol consumption plays a protective role against non‐alcoholic fatty liver disease in Japanese men with metabolic syndrome. Liver Int 2015 Jun 1;35(6)1707-14. 1;35(6):1707–14.

Published

2018-10-05

How to Cite

Escobar, D. M., Restrepo-Gutiérrez, J. C., Hoyos, S., & Navas, M. C. (2018). Effect of alcohol consumption on diagnosis of liver cirrhosis patients’ survival at a University Hospital in Medellín. Revista Colombiana De Gastroenterología, 33(3), 221–227. https://doi.org/10.22516/25007440.281

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