SNFGE SNFGE
 
Thématique :
- Foie
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2017/03  
 
  2017 Mar;65(3):929-937.  
  doi: 10.1002/hep.28943  
 
  Risk for alcoholic liver cirrhosis after an initial hospital contact with alcohol problems: A nationwide prospective cohort study.  
 
  Askgaard G, Leon DA, Kjaer MS, Deleuran T, Gerds TA, Tolstrup JS  
  https://www.ncbi.nlm.nih.gov/pubmed/27862159  
 
 

Abstract

Alcoholic liver cirrhosis is usually preceded by many years of heavy drinking, in which cessation in drinking could prevent the disease. Alcohol problems are not consistently managed in hospital patients. We followed all Danish patients with an initial hospital contact with alcohol problems (intoxication, harmful use, or dependence) during 1998-2002 for alcoholic liver cirrhosis development (n = 36,044). In this registry-based cohort, we identified predictors of the absolute risk for alcoholic liver cirrhosis. Incidence rate ratios (IRRs) were estimated as the incidence rate of alcoholic liver cirrhosis in these patients relative to the general population. Age and alcohol diagnosis were significant predictors of alcoholic liver cirrhosis risk in men and women, whereas civil status, education, and type of hospital care were not. In men, the 15-year absolute risk was 0.7% (95% confidence interval [CI], 0.4, 0.8) for 20-29 years, 5.5% (95% CI, 4.9, 6.2) for 30-39 years, 9.8% (95% CI, 9.0, 11) for 40-49 years, 8.9% (95% CI, 8.1, 9.8) for 50-59 years, 6.2% (95% CI, 5.1, 7.2) for 60-69 years, and 2.5% (95% CI, 1.7, 3.3) for 70-84 years. According to alcohol diagnosis in men, the 15-year absolute risk was 2.6% (95% CI, 2.3, 2.9) for intoxication, 7.7% (95% CI, 6.4, 7.9) for harmful use, and 8.8% (95% CI, 8.2, 9.4) for dependence. The IRR for alcoholic liver cirrhosis in the cohort relative to the general population was 11 (95% CI, 10, 12) in men and 18 (95% CI, 15, 21) in women.

CONCLUSION:

Hospital patients with alcohol problems had a much greater risk for alcoholic liver cirrhosis compared to the general population. The risk was particularly increased for patients 40-59 years and for patients diagnosed with harmful use or dependence. (Hepatology 2017;65:929-937).

 
Question posée
 
Evaluation du risque absolu de cirrhose OH et du taux d’incidence de cirrhose OH par rapport à la population générale à partir d’une cohorte danoise de patients hospitalisés pour un problème avec l’alcool.
 
Question posée
 
Chez les patients âgés de 40 à 59 ans, hospitalisés pour un problème avec l’alcool autre qu’une intoxication aiguë, le risque à 15 ans de cirrhose est de 5-6% ; ce risque est multiplié par 10 par rapport à la population générale.
 
Commentaires

Etude très intéressante. Si on peut l’envisager en France, cela permettrait d’avoir une autre approche de prévention absolument nécessaire.

 
www.snfge.org