Nikolaj Worm Orntoft1, Thomas Damgaard Sandahl2, Peter Jepsen3, Hendrik Vilstrup2. 1. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: nikolaj.oerntoft@aarhus.rm.dk. 2. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Abstract
BACKGROUND & AIMS: The incidence of acute alcoholic hepatitis is increasing, and mortality is high. However, causes of death among patients with alcoholic hepatitis have not been systematically recorded. We investigated causes of death in a population-based cohort of patients with alcoholic hepatitis who were followed for as long as 10 years. METHODS: We used the Danish National Registry of Patients to identify all patients with a first-time episode of alcoholic hepatitis from 1999 through 2008. We collected and analyzed data on 1951 patients, identifying causes of death, diagnoses of cirrhosis, and alcohol abuse. RESULTS: Of the 1951 patients, 401 died within the first 84 days after admission, and 600 died later (through December 31, 2008). Most deaths within the first 84 days after admission resulted from liver failure (40%), infections (20%), or hepatorenal syndrome (11%). Beyond 84 days, causes of deaths differed between patients with and without cirrhosis; most patients without cirrhosis (n = 326) died of causes related to alcohol abuse, whereas most patients with cirrhosis (n = 675) died of liver failure (34%), infections (16%), or variceal bleeding (11%). Cirrhosis was present in 51% of patients diagnosed with alcoholic hepatitis. Among patients without cirrhosis, 24% developed cirrhosis within 10 years; continued alcohol abuse was a strong risk factor for cirrhosis (hazard ratio, 2.14; 95% confidence interval, 1.50-3.05). The 10-year risk of a second episode of alcoholic hepatitis was 12%. CONCLUSIONS: On the basis of a study of the Danish population, the most common causes of death among patients with alcoholic hepatitis, within 84 days and within 10 years, are liver-related events and infections. Strategies are to identify and treat these complications and to reduce alcoholism.
BACKGROUND & AIMS: The incidence of acute alcoholic hepatitis is increasing, and mortality is high. However, causes of death among patients with alcoholic hepatitis have not been systematically recorded. We investigated causes of death in a population-based cohort of patients with alcoholic hepatitis who were followed for as long as 10 years. METHODS: We used the Danish National Registry of Patients to identify all patients with a first-time episode of alcoholic hepatitis from 1999 through 2008. We collected and analyzed data on 1951 patients, identifying causes of death, diagnoses of cirrhosis, and alcohol abuse. RESULTS: Of the 1951 patients, 401 died within the first 84 days after admission, and 600 died later (through December 31, 2008). Most deaths within the first 84 days after admission resulted from liver failure (40%), infections (20%), or hepatorenal syndrome (11%). Beyond 84 days, causes of deaths differed between patients with and without cirrhosis; most patients without cirrhosis (n = 326) died of causes related to alcohol abuse, whereas most patients with cirrhosis (n = 675) died of liver failure (34%), infections (16%), or variceal bleeding (11%). Cirrhosis was present in 51% of patients diagnosed with alcoholic hepatitis. Among patients without cirrhosis, 24% developed cirrhosis within 10 years; continued alcohol abuse was a strong risk factor for cirrhosis (hazard ratio, 2.14; 95% confidence interval, 1.50-3.05). The 10-year risk of a second episode of alcoholic hepatitis was 12%. CONCLUSIONS: On the basis of a study of the Danish population, the most common causes of death among patients with alcoholic hepatitis, within 84 days and within 10 years, are liver-related events and infections. Strategies are to identify and treat these complications and to reduce alcoholism.
Authors: Rachel M Lee; Adriana C Gamboa; Michael K Turgeon; Adam Yopp; Emily L Ryon; Joshua P Kronenfeld; Neha Goel; Annie Wang; Ann Y Lee; Sommer Luu; Cary Hsu; Eric Silberfein; Shishir K Maithel; Maria C Russell Journal: Am Surg Date: 2020-07-28 Impact factor: 0.688
Authors: Ashwani K Singal; Ramon Bataller; Joseph Ahn; Patrick S Kamath; Vijay H Shah Journal: Am J Gastroenterol Date: 2018-01-16 Impact factor: 10.864
Authors: Jeongeun Hyun; Zhaoli Sun; Ali Reza Ahmadi; Sushant Bangru; Ullas V Chembazhi; Kuo Du; Tianyi Chen; Hidekazu Tsukamoto; Ivan Rusyn; Auinash Kalsotra; Anna Mae Diehl Journal: J Clin Invest Date: 2020-04-01 Impact factor: 14.808
Authors: Ashwin D Dhanda; Ashish Sinha; Vicky Hunt; Sarah Saleem; Matthew E Cramp; Peter L Collins Journal: World J Gastroenterol Date: 2017-03-21 Impact factor: 5.742