Alcoholic hepatitis (AH) is the most severe form of alcoholic liver disease. Although it is commonly accepted that abstinence influences long-term survival, no studies have specifically investigated the impact and predicting factors of prolonged abstinence after an episode of AH. Here, we aimed at investigated which are the clinical, psicosocial, alcoologic parameters associated with long-term abstinence and its impact on survival.

A series of 102 patients with biopsy-proven AH seen at the Hospital Clinic of Barcelona from 2000 to 2007 were included in the study. Patients were hospitalized and received standard medical care. We describe the independent association between amount of alcohol consumed and long-term abstinence. We evaluated the effect of short term and long-term abstinence on survival.

67.4% were male, and median age was 50 years. 50.5% of the study cohort remained abstinent during the follow up period, while 49.5% of the patients admitted alcohol use at some degree during follow up. A higher score on the High-Risk Alcoholism Relapse Scale increased risk of active drinking at follow-up. When stratified by amount of alcohol consumed after admission of acute alcoholic hepatitis, those with moderate survival had median survival time of 38.2 months compared to 26.4 months in patients with severe consumption.

Early alcohol consumption after an episode of AH negatively impacts survival. The High risk Alcoholism Relapse Scale is a good predictor of long-term abstinence. Short-terms interventions in patients with AH are strongly recommended in this patient population.