Abstinence after Diagnosis of Alcohol-Related Cirrhosis is a Key Factor in Prognosis

Rates of cirrhosis are influenced by alcohol consumption, which doubled in the United Kingdom between 1960 and 2002. As a result, deaths from liver cirrhosis also increased substantially. This article reported on 7-year survival among 100 consecutive patients with alcohol-induced liver cirrhosis treated in a UK general hospital. Researchers scored liver biopsies from each patient for severity of cirrhosis then reviewed medical records to determine other clinical factors including drinking status. Results were compared with mortality data obtained from the UK National Health Service Strategic Tracing Service.

• Severity of cirrhosis had little impact on patient survival. Similar results were obtained if survival was measured from the time of first presentation of liver disease, so this effect was not related to patients undergoing biopsy later in the course of disease.
• Abstinence from alcohol one month after diagnosis was the most important factor determining survival. The 7-year survival rate was 72% for abstinent patients versus 44% for patients who continued to drink.

Comments by Tom Delaney, MSW, MPA
This article provides yet another reason to integrate substance abuse treatment with general medical care. The relationship between heavy alcohol use and cirrhosis is well known, and as such, they should be addressed concomitantly. All too often, the treatment focus is on cirrhosis. Substance abuse counselors should bring their skills to the cirrhosis treatment team immediately after a diagnosis of alcohol-related cirrhosis and provide continued abstinence support for patients over the long-term course of treatment.