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

Abstract

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