5-year mortality of alcohol-related cirrhosis: patients die just as much but not in the same manner

Background and study aim: Patients with alcohol-related cirrhosis have a poor short-term prognosis. We aimed to determine whether the 5-year mortality of alcohol-related cirrhosis has changed over the past two decades in our institution.

Patients and methods: From January 1995 to December 2014, 932 cirrhotic patients who attended the hepatology outpatient’s clinics of our institution were consecutively listed in a registry. From this registry, 565 patients had alcohol-related cirrhosis and were the subject of this study. 16 patients were excluded because they were loss to follow-up and 114 patients were excluded because the diagnosis of cirrhosis was made more than 2 years before the inclusion in the registry. We separated the 435 remaining patients into two cohorts collected during two similar period of 10-year duration, but 10 years apart: the cohort 1, patients included in the registry from 1995 to 2004 (n = 206) and the cohort 2, patients included from 2005 to 2014 (n = 229). The 5-year mortality was assessed in both cohorts and the precipitating events leading to death were compared.

Results: From the 206 patients in the cohort 1, 80 died within 5 years after the diagnosis of cirrhosis (Group A) compared to 83 patients from the 229 patients in the cohort 2 (Group B) (Cohort 1: 39 % vs Cohort 2: 36 %, p = 0.6). Patients in Group A died more often from gastrointestinal bleeding than patients in Group B (Group A: 30 % vs Group B: 9 %, p = 0.003). Patients in Group A died less by sepsis than patients in Group B (Group A: 1.5 % vs Group B: 14 %, p = 0.009).

Conclusions: The 5-year mortality rate in patients with alcoholrelated cirrhosis has not changed however, the circumstances of death have changed.

Keywords: mortality, alcohol, cirrhosis.