Introduction: Alcohol-related liver disease is recognised as a major cause of liver-related morbidity and mortality. Our aim was to report the prevalence of, and outcomes from, alcohol-related liver disease after admission to ICUs in Scotland.
Methods: We performed a secondary data analysis using linked Scottish national databases of all adult general ICUs in Scotland. We compared emergency non-surgical patients admitted to ICU with and without alcohol-related liver disease. The primary outcome was ICU mortality, and secondary outcomes were ICU admission rate ratio; 60-day mortality; 2-year mortality; duration of ICU and hospital stay; and need for hospital readmission.
Results: Of the 49,420/103,103 (47.9%) patients admitted to ICU with emergency non-surgical diagnoses between 2010 and 2018, we identified 2629/49,420 (5.3%) patients with alcohol-related liver disease. Patients with alcohol-related liver disease were more likely to receive three-organ support (14.0% vs. 10.0%, p < 0.001). Mortality in the ICU was higher in patients with alcohol-related liver disease (964/2629 (36.7%) vs. 10,517/46,791 (22.5%), respectively; aOR 2.03 (95%CI 1.85-2.24)). Patients with alcohol-related liver disease who specifically presented to ICU with a gastrointestinal bleed had a lower ICU mortality (95/487 (19.5%)). Sixty-day mortality of patients with alcohol-related liver disease increased with higher levels of organ support (186/516 (36.0%) mortality with zero organs supported vs. 162/196 (82.7%) mortality with three organs supported).
Discussion: Early mortality was high in patients with alcohol-related liver disease who were admitted to ICU, especially if multi-organ support was required. However, nearly one-fifth of patients on multi-organ support survived to hospital discharge. Early mortality for patients with alcohol-related liver disease admitted with a gastrointestinal bleed was considerably lower and should be taken into consideration when considering management in ICU. In discussion with the patient and hepatologists, a trial of organ support with continuous re-evaluation may be appropriate.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/anae.16599 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outcomes for patients with alcohol-related liver disease admitted to Scottish intensive care units 2010-2018.
Anaesthesia
March 2025
Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Introduction: Alcohol-related liver disease is recognised as a major cause of liver-related morbidity and mortality. Our aim was to report the prevalence of, and outcomes from, alcohol-related liver disease after admission to ICUs in Scotland.
Methods: We performed a secondary data analysis using linked Scottish national databases of all adult general ICUs in Scotland.
Use of Proton Pump Inhibitors Among Patients With Alcohol-Related Cirrhosis-A Danish Nationwide Cohort Study.
Liver Int
April 2025
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Background: Use of proton pump inhibitors (PPIs) may have adverse effects in patients with alcohol-related cirrhosis (ALD cirrhosis), but PPIs continue to be used by many patients.
Aims: We aimed to describe the prevalence and incidence of PPI use from filled prescriptions among patients with ALD cirrhosis and to identify predictors of PPI initiation after ALD cirrhosis diagnosis.
Methods: We used Danish nationwide healthcare registries to investigate PPI use among patients diagnosed with ALD cirrhosis from 1997 to 2022.
Contingency management to promote treatment engagement in comorbid alcohol use disorder and alcohol-related liver disease: Findings from a pilot randomized controlled trial.
Alcohol Clin Exp Res (Hoboken)
March 2025
Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Background: Alcohol-related liver disease (ARLD) is a leading cause of preventable death and health inequalities. Evidence-based interventions for comorbid alcohol use disorder (AUD) and ARLD remain limited, and only a small proportion of this clinical population engages with treatment. There is a need to improve patient outcomes by bridging this gap through novel, person-centred interventions.
View Article and Find Full Text PDF[Exploring the relationship between alcohol intake and all-cause mortality in participants with MASLD and MetALD: a study based on NHANES III data].
Zhonghua Gan Zang Bing Za Zhi
March 2025
Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China.
To evaluate the association between different levels of alcohol intake and all-cause mortality in metabolic dysfunction-associated steatotic liver disease（MASLD）and alcohol-related/associated liver disease（MetALD） This study included participants aged 20 to 74 who were diagnosed with hepatic steatosis by ultrasound. The data were derived from the Third National Health and Nutrition Examination Survey（NHANES Ⅲ）conducted in the United States from 1988 to 1994. Multivariable-adjusted hazard ratios（aHR）and their 95% confidence intervals（CI）were calculated by Cox proportional risk regression modelling to assess the effect of alcohol consumption levels on all-cause mortality.
View Article and Find Full Text PDFGlobal epidemiology of acute kidney injury in hospitalised patients with decompensated cirrhosis: the International Club of Ascites GLOBAL AKI prospective, multicentre, cohort study.
Lancet Gastroenterol Hepatol
March 2025
Unit of Internal Medicine and Hepatology, Department of Medicine, University and Hospital of Padova, Padova, Italy. Electronic address:
Background: Acute kidney injury (AKI) is a serious complication of cirrhosis. A systematic, global characterisation of AKI occurring in patients with cirrhosis is lacking. We therefore aimed to assess global differences in the characteristics, management, and outcomes of AKI in hospitalised patients with cirrhosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!