及早发现酒精使用障碍患者的肝脏疾病可提高长期戒酒率。

IF 2.1 4区 医学 Q3 SUBSTANCE ABUSE
Amelia Orgill, Michael H Jew, Maryam Soltani, Ann Deioma, Meghan Grant, Heather M Patton, Cynthia L Hsu
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引用次数: 0

摘要

目的:过度饮酒是全球关注的主要健康问题,每年导致数百万人死亡,并造成相当比例的肝硬化病例;然而,目前还缺乏早期识别酒精相关肝病的标准化方案。在这项回顾性队列研究中,我们旨在了解酒精使用障碍(AUD)高风险患者肝硬度测量(LSM)升高的患病率和相关风险因素,并确定与纵向戒酒和结果相关的变量:方法:为参加为期35天的住院药物使用治疗项目、患有严重AUD且无已知肝病的退伍军人提供肝脏健康筛查,包括纤维扫描评估。通过病历审查对AUD严重程度和肝脏健康结果进行纵向评估:在接受住院治疗的 257 名患有严重 AUD 的退伍军人中,有 185 人接受了纤维扫描评估,其中 22 人被确定为 LSM 升高,属于代偿性晚期慢性肝病。LSM 升高的患者更有可能在 1 年后继续戒酒。在 LSM≥10 kPa 的患者中,约有 41% 的患者(占所有筛查患者的 5%)在随访中被证实患有肝硬化,并被纳入常规肝病治疗范围。利用非侵入性成像模式对高危人群进行肝病筛查,为在失代偿前识别代偿性晚期慢性肝病高危患者提供了机会。发现晚期慢性肝病风险的增加可能会促进严重的 AUD 患者戒酒。心理健康专业人员和肝病专家之间的合作对于整合治疗 AUD 和肝病患者至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early detection of liver disease in patients with alcohol use disorder improves long-term abstinence.

Aims: Excessive alcohol consumption is a major global health concern, contributing to millions of deaths annually and a significant proportion of cirrhosis cases; however, standardized protocols for early identification of alcohol-associated liver disease are lacking. In this retrospective cohort study, we aimed to understand the prevalence and risk factors associated with elevated liver stiffness measurement (LSM) in high-risk patients with alcohol use disorder (AUD) and identify variables associated with longitudinal abstinence and outcomes.

Methods: Veterans with severe AUD without known liver disease admitted to a 35-day residential substance use treatment program were offered liver health screening, including Fibroscan evaluation. Assessment of AUD severity and liver health outcomes were evaluated longitudinally by chart review.

Results and conclusions: In a cohort of 257 veterans with severe AUD admitted to residential treatment, 185 underwent Fibroscan evaluation, and 22 were identified to have elevated LSM concerning for compensated advanced chronic liver disease. Patients with elevated LSM were more likely to remain abstinent after 1 year. About 41% of patients with LSM ≥ 10 kPa (5% of all screened patients) were confirmed to have cirrhosis on follow-up and incorporated into routine hepatology care. Screening of liver disease in high-risk populations with non-invasive imaging modalities provides an opportunity to identify patients at risk for compensated advanced chronic liver disease before decompensation. Identification of increased risk for advanced chronic liver disease may promote abstinence in patients with severe AUD. Collaboration between mental health professionals and hepatologists is critical for the integration of care for patients with AUD and liver disease.

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来源期刊
Alcohol and alcoholism
Alcohol and alcoholism 医学-药物滥用
CiteScore
4.70
自引率
3.60%
发文量
62
审稿时长
4-8 weeks
期刊介绍: About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.
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