Skip to main content

Research Repository

Advanced Search

Alcohol-attributable healthcare attendances up to 10 years prior to diagnosis of alcoholic cirrhosis: a population based case-control study

Otete, Harmony E.; Orton, Elizabeth; Fleming, Kate M.; West, Joe

Authors

Harmony E. Otete harmony.otete@nottingham.ac.uk

Kate M. Fleming

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology



Abstract

BACKGROUND & AIMS:
Cirrhosis because of alcohol could be avoided if drinking behaviour could be altered earlier in the disease course. Our aim was to quantify the burden of morbidities in patients prior to alcoholic cirrhosis diagnosis, as this may inform the earlier identification of people at high risk for targeted interventions.

METHODS:
We carried out a case-control study using 2479 incident cases of alcoholic cirrhosis and 24 790 controls identified from 357 primary and secondary care centres in England. We assessed the prevalence of morbidities that are partly attributable to alcohol (namely malignant neoplasms, diabetes, epilepsy, injuries, cardiovascular and digestive diseases) prior to alcoholic cirrhosis diagnosis. We compared prevalence in cases to the control population and used logistic regression to derive odds ratios (95% CI).

RESULTS:
Fifty-eight per cent of cases compared to 29% of controls had had at least one alcohol-attributable condition before cirrhosis diagnosis. The most frequent conditions (proportion in cases vs. controls) were intentional injuries (35.9% vs. 11.9%) and cardiovascular diseases (23.2% vs. 15.6%), followed by diabetes (12.8% vs. 5.3%), digestive diseases (6.1% vs. 1.2%) and epilepsy (5.0% vs. 1.1%). The strongest association with alcoholic cirrhosis was found for digestive diseases [OR 5.4 (4.4-6.7)], epilepsy [OR: 4.4 (3.5-5.5)] and injuries [OR: 4.0 (3.7-4.4)] particularly among those aged 18-44 years.

CONCLUSION:
These data highlight the high burden of other alcohol-attributable conditions in patients prior to alcoholic cirrhosis diagnosis. Reviewing those consistently presenting with any of these conditions more closely could help practitioners reduce/avoid the long-term consequences of development of alcoholic liver disease.

Citation

Otete, H. E., Orton, E., Fleming, K. M., & West, J. (2016). Alcohol-attributable healthcare attendances up to 10 years prior to diagnosis of alcoholic cirrhosis: a population based case-control study. Liver International, 36(4), https://doi.org/10.1111/liv.13002

Journal Article Type Article
Acceptance Date Oct 26, 2015
Online Publication Date Dec 29, 2015
Publication Date Apr 30, 2016
Deposit Date Nov 4, 2016
Publicly Available Date Nov 4, 2016
Journal Liver international
Print ISSN 1478-3223
Electronic ISSN 1478-3231
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 36
Issue 4
DOI https://doi.org/10.1111/liv.13002
Keywords alcoholic liver disease; comorbidities; early identification; healthcare utilization; intervention
Public URL http://eprints.nottingham.ac.uk/id/eprint/38488
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/liv.13002/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf
Additional Information This is the peer reviewed version of the following article: Alcohol-attributable healthcare attendances up to 10 years prior to diagnosis of alcoholic cirrhosis: a population based case-control study, Harmony E. Otete, Elizabeth Orton, Kate M. Fleming, Joe West, Liver Int. 2016; 36: 538–546, which has been published in final form at doi:10.1111/liv.13002. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Files


liver_international_finalproof.pdf (513 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





You might also like



Downloadable Citations