Heavy chronic alcohol abuse has no additional adverse effect on the function of extrahepatic organs and ICU mortality in patients with liver cirrhosis.
OBJECTIVE
We questioned whether heavy chronic alcohol abuse influences extrahepatic organ failure and ICU mortality in cirrhotic patients admitted to a medical intensive care unit.


METHODS
Medical records of 208 consecutive cirrhotic critically ill patients were reviewed. Patients were classified into two groups. Group A comprised 144 patients with liver cirrhosis due to heavy chronic alcohol abuse and group B, 64 patients with liver cirrhosis due to non-alcoholic causes. The presence of extrahepatic organ failures in patients of both groups was assessed with parameters determined on the day of admission to the ICU. Furthermore, ICU mortality was determined.


RESULTS
The occurrence of extrahepatic organ failure was similar in group A and group B (83% vs. 80%; p = NS). The rate of extrahepatic organ failure was 1.7 +/- 1.2 organs in group A, compared to 1.4 +/- 1 organs in group B (p = NS). ICU mortality was 53% in group A and 44% in group B (p = NS). An increase in the number of extrahepatic organ failures was associated with a concomitant increase in ICU mortality in both groups of patients.


CONCLUSIONS
The occurrence of extrahepatic organ failure and ICU mortality was not different between patients with liver cirrhosis secondary to heavy chronic alcohol abuse and patients with liver cirrhosis due to nonalcoholic causes. Cirrhotic patients should be admitted to a medical intensive care unit for extended intensive care treatment prior to the occurrence of extrahepatic multiple organ failure, independent of the underlying aetiology.
Zauner
C
C
Department of Internal Medicine IV, Universitätskliniken, Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria. Christian.Zauner@akh-wien.ac.at
Schneeweiss
B
B
Kranz
A
A
Klos
H
H
Gendo
A
A
Ratheiser
K
K
Lenz
K
K
Kramer
L
L
Madl
C
C
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000401:mortality*; D001317:Austria; D002423:Cause of Death; D003422:Critical Care; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors