Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 28, 2017; 9(36): 1332-1339
Published online Dec 28, 2017. doi: 10.4254/wjh.v9.i36.1332
Hospital contacts with alcohol problems prior to liver cirrhosis or pancreatitis diagnosis
Gro Askgaard, Søren Neermark, David A Leon, Mette S Kjær, Janne S Tolstrup
Gro Askgaard, Mette S Kjær, Department of Hepatology, Copenhagen University Hospital, Copenhagen Ø DK-2100, Denmark
Gro Askgaard, Søren Neermark, Janne S Tolstrup, National Institute of Public Health, University of Southern Denmark, Copenhagen K DK-1353, Denmark
David A Leon, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
David A Leon, Department of Community Medicine, UiT Arctic University of Norway, Tromsø 9019, Norway
Author contributions: All authors contributed to conception and design; Askgaard G and Neermark S contributed to data analysis; Askgaard G and Tolstrup JS contributed to writing the manuscript; all authors contributed to critically revising the manuscript.
Institutional review board statement: No institutional board review was conducted. This was a registry-based study only, and no such review was required due to the laws in Denmark.
Informed consent statement: No informed consent was obtained. This was a registry-based study only, and no informed consent was required due to the laws in Denmark.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gro Askgaard, MD, PhD, Department of Hepatology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen Ø DK-2100, Denmark. gro.askgaard@regionh.dk
Telephone: +45-35453545 Fax: +45-35452913
Received: August 30, 2017
Peer-review started: August 31, 2017
First decision: September 26, 2017
Revised: October 15, 2017
Accepted: November 3, 2017
Article in press: November 3, 2017
Published online: December 28, 2017
Abstract
AIM

To evaluate prior hospital contacts with alcohol problems in patients with alcoholic liver cirrhosis and pancreatitis.

METHODS

This was a register-based study of all patients diagnosed with alcoholic liver cirrhosis or pancreatitis during 2008-2012 in Denmark. Hospital contacts with alcohol problems (intoxication, harmful use, or dependence) in the 10-year period preceding the diagnosis of alcoholic liver cirrhosis and pancreatitis were identified.

RESULTS

In the 10 years prior to diagnosis, 40% of the 7719 alcoholic liver cirrhosis patients and 40% of the 1811 alcoholic pancreatitis patients had at least one prior hospital contact with alcohol problems. Every sixth patient (15%-16%) had more than five contacts. A similar pattern of prior hospital contacts was observed for alcoholic liver cirrhosis and pancreatitis. Around 30% were diagnosed with alcohol dependence and 10% with less severe alcohol diagnoses. For the majority, admission to somatic wards was the most common type of hospital care with alcohol problems. Most had their first contact with alcohol problems more than five years prior to diagnosis.

CONCLUSION

There may be opportunities to reach some of the patients who later develop alcoholic liver cirrhosis or pancreatitis with preventive interventions in the hospital setting.

Keywords: Alcoholic liver disease, Alcoholic pancreatic disease, Nationwide, Prevention, Hospital contacts

Core tip: Alcohol-related liver and pancreatic disease are preceded by many years of heavy drinking. Hospital contacts with obvious alcohol problems prior to development of alcohol-related liver or pancreatic disease may constitute opportunities for prevention if alcohol problems were to be consistently managed. In this study of all Danish alcoholic liver cirrhosis and alcoholic pancreatitis patients, forty percent had at least one previous hospital contact with obvious alcohol problems in the 10 years prior to diagnosis. Most of these patients had their first contact with alcohol problems more than five years prior to diagnosis.