[Descriptive epidemiology of patients with alcoholic liver disease hospitalized in a hepato-gastroenterology service]. / Analyse descriptive des malades ayant une maladie alcoolique du foie hospitalisés dans un service d'Hépato-Gastroentérologie.

ABSTRACT

OBJECTIVE: To improve the detection of early stage alcoholic liver disease and to identify the importance of this disease, this study compared epidemiological characteristics, the reasons for and the duration of hospitalization, in-patient mortality and the frequency of multiple hospitalizations in alcoholic patients without cirrhosis and in patients with alcoholic cirrhosis hospitalized in the hepatogastroenterology department of Antoine-Beclere Hospital. MATERIAL AND METHODS: From January 1982 to December 1995, all patients with a daily alcohol intake in the previous year of at least 50 g per day and all patients with alcoholic cirrhosis whatever their drinking habits were studied. RESULTS: Three thousand three hundred and forty six patients were included. The daily alcohol intake in the previous five years was 118 +/- 81 g and the duration of alcohol abuse was 22 +/- 13 years. Two thousand one hundred eight patients had liver biopsy; 37% had histologically proven or probable cirrhosis. Forty one percent of the patients without cirrhosis who had liver biopsy already had steatofibrosis and/or acute alcoholic hepatitis. 32.5% of the patients had hepatitis B virus markers. 7.7% of the patients were positive for anti hepatitis C virus antibody. Thirty two percent of the patients with cirrhosis were women versus 22% of the patients without cirrhosis (P < 0.01). Alcoholism was the reason for the first hospitalization in sixty percent of the patients without cirrhosis and in twenty percent of the patients with cirrhosis (P < 0.01). On the other hand, ascites were the first reason for the first hospitalization in patients with cirrhosis (28%). The two main causes for multiple hospitalizations were also ascites and alcoholism. CONCLUSION: Two thirds of heavy drinkers did not have cirrhosis on admission since alcoholism was the first reason for multiple hospitalizations in these patients, therefore the management of alcoholism in out-patients must be improved.