Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Lackner, C; Spindelboeck, W; Haybaeck, J; Douschan, P; Rainer, F; Terracciano, L; Haas, J; Berghold, A; Bataller, R; Stauber, RE.
Histological parameters and alcohol abstinence determine long-term prognosis in patients with alcoholic liver disease.
J Hepatol. 2017; 66(3):610-618
Doi: 10.1016/j.jhep.2016.11.011
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Lackner Karoline
- Co-Autor*innen der Med Uni Graz
- Berghold Andrea
- Douschan Philipp
- Haas Josef
- Haybäck Johannes
- Rainer Florian
- Spindelböck Walter Johann
- Stauber Rudolf
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- Abstract:
- Few data exist on predictors of long-term prognosis in patients with alcoholic liver disease (ALD). Most studies have only assessed short-term prognosis in patients with advanced ALD. We aimed to assess the prognostic impact of clinical, biochemical and histological parameters on long-term prognosis in patients with early/compensated and decompensated ALD. Consecutive patients (n=192) with biopsy-proven liver disease due to alcohol abuse were analyzed retrospectively. Prognostic factors were evaluated in patients with early/compensated ALD (n=60) and in patients with decompensated ALD (clinical decompensation and/or bilirubin >3mg/dl at entry) (n=132). Factors that predict long-term survival were identified using Cox regression models. Liver-related mortality at 5years was 13% in early/compensated and 43% in decompensated ALD. In early/compensated ALD patients, long-term prognosis was determined by fibrosis stage, but not by clinical or biochemical variables. Severe fibrosis (F3/4) was present in 52% and had a major impact on 10-year mortality (F3/4: 45% vs. F0-2: 0%, p<0.001). In contrast, in decompensated patients, a combination of clinical features (sex), biochemical markers of liver failure (bilirubin, international normalized ratio [INR]), and histological features (pericellular fibrosis) predicted long-term survival. During follow-up, abstinence from alcohol was an important predictor of survival in both early/compensated and decompensated ALD. Fibrosis stage is the main predictor of long-term survival in patients with early/compensated ALD, while clinical, biochemical and histological parameters predict survival in patients with decompensated disease. Promoting abstinence may improve survival in patients with both early and advanced ALD. In this study, we evaluated long-term outcome in 192 patients with alcoholic liver disease who underwent liver biopsy: 60 patients with early disease (no symptoms) and 132 patients with advanced disease (jaundice, complications of cirrhosis). Importantly, half of the patients with 'early' disease already had severe fibrosis or cirrhosis on liver histology and dismal outcome (45% mortality at 10years). Abstinence from alcohol improved the prognosis in both early and advanced stages of the disease. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Alcohol Abstinence -
- Bilirubin - blood
- Cohort Studies -
- Female -
- Humans -
- Kaplan-Meier Estimate -
- Liver Diseases, Alcoholic - metabolism
- Liver Diseases, Alcoholic - pathology
- Liver Diseases, Alcoholic - psychology
- Male -
- Middle Aged -
- Prognosis -
- Proportional Hazards Models -
- Retrospective Studies -
- Young Adult -
- Find related publications in this database (Keywords)
- Liver diseases
- Alcoholic
- Hepatic fibrosis
- Biopsy
- Liver failure
- Retrospective studies