Detection of Advanced Chronic Liver Disease in Patients With Alcohol Use Disorder in the Hospital Detoxification Unit

There is very little recent data on the prevalence of advance chronic liver disease in high-risk patients, particularly in our region, making studies evaluating this necessary.

In the European clinical practice guidelines (EASL Clinical Practice Guidelines: Management of Alcohol-Related Liver Disease), it is recommended to screen for advance chronic liver disease in high-risk populations such as patients in rehabilitation and detox clinics and heavy drinkers. advance chronic liver disease should be considered in patients presenting with extrahepatic manifestations of alcohol use disorder, such as peripheral symmetric neuropathy, pancreatitis, and cardiomyopathy, among others.

Screening for liver disease in high-risk groups should not only include liver function tests (e.g., gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT], or aspartate aminotransferase [AST]) but also include testing for liver fibrosis (e.g., transient elastography such as FibroScan®), given that advanced liver disease may occur in patients with normal liver profiles.

If any abnormalities are detected in liver profiles or elastography, an abdominal ultrasound should be performed to rule out hepatocellular carcinoma and a complete liver disease study should be carried out to exclude alternative or additional causes of liver damage. Current clinical guidelines (Spanish, European, and American) do not specify which tools to use in each risk subgroup.

The primary objective is to assess the prevalence of advance chronic liver disease measured by transient elastography in patients admitted to the Hospital Detoxification Unit and the acute psychiatric unit with dual pathology and harmful alcohol consumption.