Transient elastography in acute hospital inpatients with harmful alcohol use: a service evaluation
Alfred John Balston1, Isabella Conti2, Sandra Darko1
1Addiction Care Team, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom.
Aims:
Hospital admissions are frequently alcohol related and are an opportunity for health promotion. Transient Elastography (TE), an ultrasound-based method of assessing liver health, may be beneficial when used by inpatient Alcohol Care Teams (ACTs). We evaluated the integration of TE in an inpatient ACT, the rate of liver fibrosis detection, and the engagement and drinking behaviour of those with raised liver stiffness at follow-up.
Methods:
A retrospective service evaluation of inpatients ≥18 years old that underwent ACT-led TE between June 2022 and December 2023 at an acute hospital. Inpatients were eligible for TE if they consumed more than 35 units of alcohol per week if female and more than 50 units per week if male. Significant liver fibrosis was defined as ≥8 kPa.
Results:
319 patients underwent TE of whom 119 (37%) had increased liver stiffness. Of 64 patients referred for local follow-up, 26 (41%) attended a first appointment. Self-reported alcohol consumption reduced in 17 of these 26 patients (65%), increased in two (7%) patients, did not change in two (7%) patients, and was unrecorded in five (19%) patients. No follow-up data were collected on patients with normal liver stiffness.
Conclusions:
Hospital admissions present an opportunity for detection of chronic liver disease that would otherwise remain undiagnosed in an at-risk population via ACT integrated TE. Of the few patients with raised liver stiffness that attended follow-up, most decreased their alcohol consumption or were abstinent. The outcomes of those with normal liver stiffness are not known.
