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• W4386886504 abstract "<h3>Background and Aims</h3> Europe has the highest per capita alcohol consumption and alcohol-related loss of disability adjusted life years compared with other WHO regions, with many countries seeing a rapid rise in alcohol related harms. Despite this, there is still widespread failure to recognise alcohol-related liver disease early before patients present with decompensation. Many patients with alcohol use disorder present frequently with unscheduled admissions to hospital, providing an opportunity for engagement with addiction and hepatology services. We sought to evaluate opportunistic testing for cirrhosis in this vulnerable patient group who often experience barriers to accessing healthcare. <h3>Method</h3> Our transient elastography (TE)-trained alcohol specialist nurses (ASNs) offered TE to patients with alcohol dependence and no previous diagnosis of cirrhosis. Those with elevated liver stiffness measurements (LSM) of ≥ 12 kPa were offered follow up in hepatology clinic or assessed during their admission by a hepatologist. Paired t-test was used to assess mean differences between groups pre- and post- intervention. <h3>Results</h3> Between April and December 2022, 87 patients at the Bristol Royal Infirmary, UK were offered TE during emergency admissions by ASNs (23% F; median age 55 (IQR 18.5)). 25 people (28.7%) with LSM of ≥ 12 kPa (median IQR/M 11.5%) were identified as having probable alcohol related cirrhosis. Of these, 9 had LSM ≥ 25 kPa suggestive of clinically significant portal hypertension (CSPH). Attendance at hepatology clinic appointment follow up with phone reminder from a support worker was 80% (n=20/25). Where documented (n=61/87) a trend towards lower units consumed post ASN review and TE assessment was observed; pre-admission mean alcohol consumption was 29.6 units/day (SD: 20.9) falling to 14.6 units/day (SD:17.6; t(60) = 34.3; p = <0.0001) post-admission. Of the 87 patients screened, 8 died within the nine month period, 4 of whom had been identified as having cirrhosis. <h3>Conclusion</h3> Opportunistic testing for liver disease in people with alcohol use disorder is important and high yield to identify patients with cirrhosis and clinically significant portal hypertension. Crucially this is a socially disadvantaged patient cohort who experience barriers to accessing traditional healthcare. Prospective work is needed to establish whether diagnosis has a lasting impact on drinking behavior, engagement with addiction services, liver related morbidity and mortality." @default.
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• W4386886504 date "2023-09-01" @default.
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• W4386886504 title "P23 Opportunistic cirrhosis casefinding in alcohol dependent inpatients through alcohol specialist nurse assessment and transient elastography: early detection in a high-risk group" @default.
• W4386886504 doi "https://doi.org/10.1136/gutjnl-2023-basl.39" @default.
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