{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:22:27Z","timestamp":1790180547218,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2021,10,3]],"date-time":"2021-10-03T00:00:00Z","timestamp":1633219200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>\n                    Alcohol use can cause hepatic necroinflammation and worsening portal hypertension in patients with cirrhosis. We aimed to evaluate the associations between degree of alcohol use and clinical liver\u2010related outcomes according to etiology of cirrhosis. In this retrospective cohort analysis, 44,349 U.S. veterans with cirrhosis from alcohol\u2010associated liver disease (ALD), chronic hepatitis C virus (HCV) infection, or nonalcoholic fatty liver disease were identified who completed the Alcohol Use Disorders Identification Test Consumption questionnaire in 2012. Based on this score, level of alcohol use was categorized as none, low level, or unhealthy. Multivariable Cox proportional hazards regression was used to assess for associations between alcohol use and mortality, cirrhosis decompensation (new ascites, encephalopathy, or variceal bleeding), and hepatocellular carcinoma (HCC). At baseline, 36.4% of patients endorsed alcohol use and 17.1% had unhealthy alcohol use. During a mean 4.9\u00a0years of follow\u2010up, 25,806 (57.9%) patients died, 9,409 (21.4%) developed a new decompensation, and 4,733 (11.1%) developed HCC. In patients with ALD\u2010cirrhosis and HCV\u2010cirrhosis, unhealthy alcohol use, compared with no alcohol use, was associated with higher risks of mortality (adjusted hazard ratio [aHR]\u00a0=\u00a01.13, 95% confidence interval [CI]\u00a0=\u00a01.07\u20101.19 and aHR\u00a0=\u00a01.14, 95% CI\u00a0=\u00a01.08\u20101.20, respectively) and decompensation (aHR\u00a0=\u00a01.18, 95% CI\u00a0=\u00a01.07\u20101.30 and aHR\u00a0=\u00a01.08, 95% CI\u00a0=\u00a01.00\u20101.16, respectively). Alcohol use was not associated with HCC, regardless of cirrhosis etiology.\n                    <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>\n                    : Unhealthy alcohol use was common in patients with cirrhosis and was associated with higher risks of mortality and cirrhosis decompensation in patients with HCV\u2010cirrhosis and ALD\u2010cirrhosis. Therefore, health care providers should make every effort to help patients achieve abstinence. The lack of association between alcohol use and HCC merits further investigation.\n                  <\/jats:p>","DOI":"10.1002\/hep4.1776","type":"journal-article","created":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T16:10:52Z","timestamp":1633363852000},"page":"2080-2095","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":43,"title":["Associations Between Alcohol Use and Liver\u2010Related Outcomes in a Large National Cohort of Patients With Cirrhosis"],"prefix":"10.1097","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6884-9594","authenticated-orcid":false,"given":"Meredith M.","family":"Pearson","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Washington,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2348-0580","authenticated-orcid":false,"given":"Nicole J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Washington,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Berry","sequence":"additional","affiliation":[{"name":"Health Service Research and Development,Veterans Affairs Puget Sound Health Care System,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7163-2062","authenticated-orcid":false,"given":"Andrew M.","family":"Moon","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of North Carolina,Chapel Hill,NC,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Su","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Washington,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Vutien","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Washington,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela K.","family":"Green","sequence":"additional","affiliation":[{"name":"Health Service Research and Development,Veterans Affairs Puget Sound Health Care System,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Williams","sequence":"additional","affiliation":[{"name":"Health Service Research and Development,Veterans Affairs Puget Sound Health Care System,Seattle,WA,USA"},{"name":"Department of Health Services,University of Washington,Seattle,WA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1796-8977","authenticated-orcid":false,"given":"George 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