Outcomes of patients with alcohol-related cirrhosis referred to a hepatology outpatient clinic

Background and Aims Achieving abstinence is the most effective treatment of alcohol-related cirrhosis even if already decompensated. Patients with cirrhosis and alcohol use disorder (AUD) represents a special population and should be treated by a multidisciplinary team with a mandatory experience in addiction medicine (2020 AISF guidelines). This study aims to assess the outcome of patients with cirrhosis and alcohol-related cirrhosis referred to a hepatological service provided of an internal multidisciplinary alcohol unit. Methods Retrospective observational study assessing clinical trajectories and survival of patients with alcoholic cirrhosis referred to our hepatological service from 2016 to 2022 Prolonged abstinence was assessed by means of clinical and laboratory parameters. Results 175 patients (median age: 54 years; 77% male) were included. About 35% of patients had also a viral etiology and 26% MASLD. About 60% were decompensated, median MELD was 13 and MELD-Na 16. About 40% patients discontinued alcohol consumption at the hepatological evaluation without referral to the alcohol unit. About 45% accepted to be followed by the multidisciplinary alcohol team; of these patients, almost 35% achieved prolonged abstinence, while the remaining had several episodes of AUD recurrence alternating periods of abstinence in most cases. Interestingly, these latter patients showed an intermediate survival between abstinent individuals and active drinkers. Only 15% of patients refused any support and continued alcohol consumption. Clinical and socio-economic differences were observed among groups. Conclusions This study showed that, besides many patients able to stop drinking at the time of diagnosis of cirrhosis, combining a multidisciplinary alcohol unit embedded in a hepatological service is an effective approach for patients with cirrhosis and DUA even when prolonged abstinence is not fully achieved.