48 A NATIONWIDE STUDY OF THE INCIDENCE AND MORTALITY RATE OF ALCOHOLIC HEPATITIS IN DENMARK, 1999–2008

Abstract

Background: Alcoholic hepatitis is a lifeand health-threatening disease covering a wide clinical spectrum. Accurate and representative data on its incidence and prognosis are scarce. Aim: To provide population based crude and adjusted (age, sex and cirrhosis) incidence and mortality rates for patients with alcoholic hepatitis, using a 10-year study period. Methods: Using administrative registers; we identified all patients with a first time diagnosis of alcoholic hepatitis in Denmark from 1999 to 2008, and their dates of death. A simultaneous diagnosis of cirrhosis was also registered. We computed the annual ageand sex-standardized incidence rate as well as 28-, 84-day and longterm mortality rates. Results: We identified 1951 patients, 63% men. During the study time, the annual incidence rate rose from 37 to 46 per 1.000.000 for men and from 24 to 34 per 1.000.000 for women. The 28day mortality rate rose from 12% to 15% over time (no gender difference). The 84-day mortality rate rose from 14% to 24%. The rise in short term mortality was dependable on a rise in patient mean age and cirrhotic comorbidity and there was no difference in short-term mortality after adjusting for these factors. Overall 5-year survival was 44%, 53% without cirrhosis and 31% with cirrhosis. Conclusions: This population-based study spanning 10 years describes an increasing incidence rate and short-term mortality of patients with alcoholic hepatitis. Patients with Alcoholic hepatitis have a high shortand long-term mortality, the latter highly dependable on the presence of cirrhosis. The increase in mortality can be explained by a higher frequency of cirrhosis on admission combined with increasing patient age. Our data does not support causal conclusions on the increase in incidence, age and cirrhosis, but we believe that changes in diagnostic approach or the observed increase in people who drink more than the recommended limit. 49 OSTEOPONTIN IS A NOVEL THERAPEUTIC TARGET IN PATIENTS WITH ALCOHOLIC HEPATITIS O. Morales, M. Dominguez, E. Juez, M. Moreno, R. Miquel, J.J. Lozano, J. Colmenero, J.C. Garcia-Pagan, V. Arroyo, P. Gines, J. Caballeria, R. Bataller. Liver Unit, Pathology Unit, Hospital Clinic i Provincial de Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain E-mail: oriol.morales@ciberehd.org