Factors associated with mortality in women with decompensated alcohol-related cirrhosis

Introduction and aims

Alcohol-related liver disease is becoming more common worldwide. Recently, alcohol consumption in women has increased significantly, raising the risk of developing alcohol-associated hepatitis, cirrhosis, and hepatocellular carcinoma. Greater susceptibility to alcohol-related liver damage appears to confer a higher mortality and decompensation risk on women. Our study aimed to assess alcohol consumption patterns and mortality rates in female patients with alcohol-related cirrhosis.

Material and methods

We conducted a single-center retrospective cohort study of patients hospitalized for cirrhosis due to chronic alcohol consumption at the Hospital General de Mexico, "Dr. Eduardo Liceaga" between 2018 and 2021. Utilizing the patients’ electronic medical records, alcohol consumption patterns were identified and the survival rate for women and men after their first hospitalization was calculated through the Kaplan-Meier curve.

Results

A final total of 192 electronic medical records (50% women) were included. We classified the patients according to alcohol consumption into a) excessive consumption or b) binge drinking. The median age for the onset of chronic alcohol consumption was higher in women than in men (18 vs. 16.5 years of age; p = 0.0001). The median for alcohol consumption in g/occasion was lower in women than in men (140 vs. 275 in excessive alcohol consumption and 196 vs 320 in binge drinking; p = 0.0001), as was the length of time of chronic alcohol consumption (24.5 vs. 30 years; p = 0.0001)

The mortality rate during the first hospitalization was 32.8% (61.9% for women and 38.9% for men). The mean age for survival was lower for women (33.8 ± 1.6 years of age, 95% CI 30.5–37.1), compared with men (37.0 ± 1.2 years of age, 95% CI 35.4–38.6) (p = 0.002). The factors associated with mortality in the Cox proportional hazards models were women vs men (OR = 4.1, 95% CI 2.1–7.9) and excessive consumption vs binge drinking (OR = 1.9, 95% CI 1.1–3.5).

Conclusions

Alcohol-related mortality is higher in women than in men and is associated with lower alcohol consumption, a shorter period of continued chronic consumption, and an older age at consumption onset.