Alcohol‐related cirrhosis—early abstinence is a key factor in prognosis, even in the most severe cases

Abstract

AIMS: To determine the effect of pathological severity of cirrhosis on survival in patients with alcohol-related cirrhosis. DESIGN: Liver biopsies from 100 patients were scored for Laennec score of severity of cirrhosis, and medical notes were reviewed to determine various clinical factors, including drinking status. Up-to-date mortality data were obtained using the National Health Service Strategic Tracing Service. SETTING: Southampton General Hospital between 1 January 1995 and 31 December 2000. PARTICIPANTS: A total of 100 consecutive patients with biopsy proven alcohol-induced liver cirrhosis. MEASUREMENTS: Laennec score of severity of cirrhosis and mortality. FINDINGS: Most surprisingly, the severity of cirrhosis on biopsy had little impact on survival; indeed, early death was more likely in patients with the least severe cirrhosis. Abstinence from alcohol at 1 month after diagnosis of cirrhosis was the more important factor determining survival with a 7-year survival of 72% for the abstinent patients versus 44% for the patients continuing to drink. CONCLUSIONS: It is never too late to stop drinking, even with the most severe degrees of cirrhosis on biopsy. Early drinking status is the most important factor determining long-term survival in alcohol-related cirrhosis.