Increased risk of esophageal varices, liver cancer, and death in patients with alcoholic liver disease.
OBJECTIVE
During the last decades, a multitude of different treatments for chronic liver disease have been introduced. New surveillance programs have been established to detect esophageal varices and liver cancer. The aims of our study were to assess whether the prognosis for patients hospitalized with liver diseases between 1969 and 2006 had improved and to study the differences in mortality and complications between patients with alcoholic liver disease and nonalcoholic liver diseases.


METHODS
We used the Swedish Hospital Discharge Register and Cause of Death Register at the National Board of Health and Welfare in Sweden between 1969 and 2006 to identify and follow-up a cohort of patients with liver disease according to the International Classification of Diseases-8, -9, and -10.


RESULTS
There were 36,462 patients hospitalized with alcoholic and 95,842 with nonalcoholic liver diseases. The main finding was that patients hospitalized with alcoholic liver disease had an increased mortality risk, compared to patient with nonalcoholic liver disease, 1.89 (1.85 to 1.92). In addition, the patients with alcoholic liver disease had an increased risk for esophageal varices and liver cancer. There was a reduced risk for hospitalization with esophageal varices for patients with nonalcoholic liver disease up to 1998.


CONCLUSIONS
We found that the prognosis for patients hospitalized with chronic liver diseases had not improved. Patients with alcoholic liver disease have an increased risk of complications, which suggest that the disease is more aggressive and are in need of closer follow-up than other chronic liver diseases.
Stokkeland
Knut
K
Department of Medicine, Visby Hospital, SE-622184 Visby, Sweden. knut.stokkeland@gotland.se
Ebrahim
Fereshte
F
Ekbom
Anders
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000453:epidemiology / Q000401:mortality; D008108:Liver Diseases, Alcoholic / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012044:Regression Analysis; D018570:Risk Assessment; D013548:Sweden / Q000453:epidemiology