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

Addiction. 2009 May;104(5):768-74. doi: 10.1111/j.1360-0443.2009.02521.x. Epub 2009 Mar 13.


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.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Liver Cirrhosis, Alcoholic / mortality*
  • Liver Cirrhosis, Alcoholic / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Severity of Illness Index*
  • Survival Analysis
  • Time Factors
  • Young Adult