Research Article Details

Article ID: A47014
PMID: 30048873
Source: Drug Alcohol Depend
Title: Ultrasound findings of liver damage in a series of patients consecutively admitted for treatment of alcohol use disorder.
Abstract: BACKGROUND: To analyze ultrasound findings of liver damage in alcohol use disorder (AUD) patients. METHODS: A cross-sectional analysis of detoxification patients. Clinical and laboratory parameters were obtained at admission. Analytical liver injury (ALI) was defined as at least two of the following: aspartate aminotransferase (AST) levels &#8805;74&#8239;<&#8239;300 U/L, AST/alanine aminotransferase (ALT) ratio >2, and total bilirubin >1.2&#8239;mg/dL. Advanced liver fibrosis (ALF) was defined as a FIB-4 score &#8805;3.25. Abdominal ultrasound was used to identify steatosis, hepatomegaly, heterogeneous liver, and portal hypertension. Predictors of these findings were determined by logistic regression. RESULTS: We included 301 patients (80% male) with a median age of 46 years (IQR: 39-51 years) and alcohol consumption of 180&#8239;g/day (IQR: 120-201&#8239;g). The prevalence of Hepatitis C virus (HCV) was 21.2%; AST and ALT serum levels were 42 U/L (IQR: 23-78 U/L) and 35 U/L (IQR: 19-60 U/L), respectively; 16% of patients had ALI and 24% ALF. Ultrasound findings were: 57.2% steatosis, 49.5% hepatomegaly, 17% heterogeneous liver, and 16% portal hypertension; 77% had at least one ultrasound abnormality, and 45% had &#8805;2. HCV infection was associated with heterogeneous liver (p&#8239;=&#8239;0.046) and portal hypertension (p&#8239;<&#8239;0.01). ALI and ALF were associated with steatosis (both p&#8239;<&#8239;0.01) and hepatomegaly (both p&#8239;<&#8239;0.01), ALI with portal hypertension (p&#8239;=&#8239;0.08), and ALF with heterogeneous liver (p&#8239;<&#8239;0.01). In logistic regression, ALI and ALF were associated with &#8805;2 abnormalities [OR (95%CI): 5.2 (2.1-12.8), p&#8239;<&#8239;0.01 and 4.7 (2.2-9.7), p&#8239;<&#8239;0.01; respectively]. CONCLUSIONS: Ultrasound findings of liver damage may facilitate clinical decisions and alcohol cessation in AUD patients.
DOI: 10.1016/j.drugalcdep.2018.06.012