Patients with alcoholic liver disease hospitalized in Hepatogastroenterology. A French national multicenter investigation

Objectives - To describe the characteristics of in-patients with alcoholic liver disease in Hepatogastroenterology and to evaluate whether geographic location was a risk Factor for cirrhosis. Methods - A French, national, multicenter, prospective investigation was pe rformed in the last quarter of 1997. To be included in the study, patients had to have drunk at least 50 g of alcohol per day for the past year or to have cirrhosis. Results - Seventeen centers included 802 patients 20% had histologically pr oven cirrhosis or probable cirrhosis. Thirty-five percent had undergone liv er biopsy. Twenty Five percent of these patients had cirrhosis without acut e alcoholic hepatitis and 37% had cirrhosis with acute alcoholic hepatitis. After dividing France along a Bordeaux-Strasbourg axis, there was more his tologically proven or probable cirrhosis in the North (46%) than in the Sou th (36%) (P < 0.005) while daily alcohol intake was greater the South (150 +/- 6 g) than in the North (129 +/- 4 g) (P < 0.0001). When the six variabl es (age, sex, daily consumption of alcohol over the past 5 years, presence of hepatitis B surface antigen and antibodies to hepatitis C virus, total d uration of alcohol abuse) were considered together in stepwise logistic reg ression analysis, geographic location changed the prediction of cirrhosis. The odds ratio for cirrhosis in patients living to the North of the Bordeau x-Strasbourg axis was 1.9 (95% confidence interval range 1.1-3.2) (P < 0.02 ), suggesting the role of nutritional factors.