Alcohol-related cirrhosis--early abstinence is a key factor in prognosis, even in the most severe cases.
OBJECTIVE
To determine the effect of pathological severity of cirrhosis on survival in patients with alcohol-related cirrhosis.


METHODS
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.


METHODS
Southampton General Hospital between 1 January 1995 and 31 December 2000.


METHODS
A total of 100 consecutive patients with biopsy proven alcohol-induced liver cirrhosis.


METHODS
Laennec score of severity of cirrhosis and mortality.


RESULTS
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.
Verrill
Clare
C
Department of Histopathology, Southampton General Hospital, Southampton, UK. clareverrill@hotmail.com
Markham
Hannah
H
Templeton
Alexa
A
Carr
Norman J
NJ
Sheron
Nick
N