Effect of abstinence from alcohol on survival of patients with alcoholic cirrhosis: A systematic review and meta-analysis

Authors

  • Yan-Di Xie,

    1. Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, China
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  • Bo Feng,

    1. Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, China
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  • Yan Gao,

    1. Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, China
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  • Lai Wei

    Corresponding author
    1. Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, China
    • Correspondence: Professor Lai Wei, Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China. Email: weilai@pkuph.edu.cn

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  • Author contributions: L. W. and Y. D. X. proposed the study; Y. D. X. and B. F. performed research and wrote the first draft; Y. D. X. and B. F. selected the data; and Y. D. X., B. F. and Y. G. analyzed the data. All authors contributed to the design and interpretation of the study and to further drafts.
  • Funding: We received no funding for this study.
  • Ethical approval: Not needed.
  • Conflict of interest: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Abstract

Aim

To address the questions of whether abstinence improves survival of patients with alcoholic cirrhosis (AC) and how long it takes for the effect to be significant.

Methods

A systematic review and a meta-analysis are performed to assess the effect of abstinence on the survival of patients with AC.

Results

Seven cohort studies involving 1235 patients with AC were included. No differences were found in 0.5-year survival (hazard ratio [HR] = 0.48, 95% confidence interval [CI] = 0.23–1.03, P = 0.06) and 1-year survival (HR = 0.58, 95% CI = 0.32–1.03, P = 0.06) between the abstinent and continue drinking groups. However, differences were found in 1.5-year survival (HR = 0.51, 95% CI = 0.33–0.81, P = 0.004), 2-year survival (HR = 0.55, 95% CI = 0.38–0.78, P = 0.0008), 2.5-year survival (HR = 0.54, 95% CI = 0.38–0.77, P = 0.0005), 3-year survival (HR = 0.54, 95% CI = 0.40–0.74, P = 0.0001), 3.5-year survival (HR = 0.56, 95% CI = 0.44–0.73, P < 0.00001), 4-year survival (HR = 0.60, 95% CI = 0.48–0.73, P < 0.00001), 4.5-year survival (HR = 0.61, 95% CI = 0.49–0.76, P < 0.0001) and 5-year survival (HR = 0.63, 95% CI = 0.52–0.76, P < 0.00001) between the two groups.

Conclusion

Alcohol abstinence does improve the survival of patients with AC, and it takes at least 1.5 years of alcohol abstinence before a statistically significant difference in survival can be observed between the abstinent and the continue drinking groups.

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