Survival in a 10 year prospective cohort of heavy drinkers: Liver stiffness is the best long-term prognostic parameter

Background Alcoholic liver disease (ALD) is among the most common liver diseases in the western world. We here present first data on the prognostic impact of LS on 10 years long-term survival of Caucasian heavy drinkers.

Method Information of survival was obtained in 675 of 943 screened patients that had presented for alcohol detoxification (6.0 days) over a period from 2007–2017 with a mean daily consumption of alcohol of 178 g. Mean observation time was 3.7 years. All patients had LS measurements by transient elastography and routine laboratory tests.

Results During the observation time, 106 patients died. Overall death was highest associated with LS, followed by hemoglobin and alkaline phosphatase (AP). In a multivariate model, LS next to age, AP and hemoglobin was the most significant independent predictor of survival with a hazard ratio of 1.013 (1.003 to 1.023, P < 0.05). Using ROC analysis, LS was the best predictor of death in general with an AUROC of 0.72 and a cutoff value of 14.0 kPa, followed by AP. Moreover, LS was the top predictor of death starting from 2 to 5 years. When stratifying patients according to standard LS cut-off values < 6 kPa, 6 to 12.5 kPa and > 12.5 kPa, 3-year survival rate was 94%, 88% and 74% and 5-year survival rate was 90%, 78% and 64%, respectively.

Conclusion We here identify LS as the best long-term prognostic parameter in patients who heavily consume alcohol. LS measurements should become an important parameter for the screening of alcoholics.

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Artikel online veröffentlicht:
26. Januar 2022