Long-term mortality in alcohol-related liver disease: Insights from a 15-year follow-up

Patients with alcohol-related liver disease face a high risk of death due to liver disease long after diagnosis, with specific cancers like hepatocellular carcinoma contributing less significantly to overall mortality.

Understanding the causes of death after an alcohol-related liver disease diagnosis is crucial for prevention of early death. A recent study investigated mortality patterns and causes of death in the years following diagnosis of alcohol-related liver illness.

Using nationwide health registries, researchers tracked 23,385 patients aged 18 and older diagnosed with alcohol-related liver disease, following their mortality up to December 2019. They analyzed mortality by cause, age, sex, severity of liver ailment (decompensated cirrhosis, compensated cirrhosis, alcoholic hepatitis, and steatosis or unspecified liver illness), and diabetes status.

During the follow-up of 111,532 person-years, 15,692 patients (67%) died with liver disease as the main cause. About 66% of the patients had cirrhosis. Liver disease was the key cause of death, with a 5-year death risk due to liver disease of 25.8%. After 5 years, other causes like cancer, cardiovascular disease, and alcohol use disorder became more common.

Hepatocellular carcinoma (10-year risk of 2.5%) and lung cancer (1.9%) were prominent among cancer deaths. The 10-year risk of death from liver disorder was about 30% across all age groups, sexes, and diabetes statuses. However, it was three times more for those having decompensated cirrhosis (46.7%) compared to those suffering from steatosis or unspecified liver disease (16.2%).

Alcohol-related liver disease remains a significant cause of death for many years post-diagnosis, regardless of age (<50, 50-59, and ≥60 years), sex, or diabetes. While cancers like hepatocellular carcinoma do occur, they contribute less to overall mortality compared to the persistent risk of liver disease itself.