{
  "abstract": "Background Alcohol-related liver disease (ArLD) encompasses a spectrum of liver conditions including steatosis, alcoholic hepatitis (AH), and cirrhosis. It is a leading cause of liver-related morbidity and mortality in the UK. However, the impact of ArLD on health-related quality of life (HRQoL) remains underexplored. This study explores HRQoL in people living with ArLD.Methods ALLHEAL is a prospective multi-centre cohort study involving adults with, or at risk of, ArLD from 19 sites across England. Demographic and clinical data, including comorbidities, were collected from electronic health records. Liver disease was classified as absent, steatosis, AH, or cirrhosis. Cirrhosis was further classified as compensated or decompensated based on clinical features (ascites, variceal bleeding, or encephalopathy). Disease severity was assessed with the model for end-stage liver disease (MELD) score. Alcohol use was quantified using the AUDIT questionnaire and self-reported intake. HRQoL was measured using the EQ-5D framework capturing five domains – mobility, self-care, activity, pain, anxiety/depression – and a visual analogue scale (VAS) scale (0–100). Univariable and multivariable logistic regression analysis were used to identify associations between HRQoL and clinical variables.Results Data from 628 patients was analysed (median age 54 years, 70% male). 59 patients did not have any known liver disease, 280 patients had liver disease: 88 had steatosis only, 21 had AH, and 171 had cirrhosis. Of the cirrhosis patients, 103 had compensated and 68 had decompensated liver disease. The median AUDIT score was 24 (IQR: 13–32) and the median EQ-5D visual analogue scale (VAS) score was 50 (IQR: 35–75). HRQoL declined with worsening liver disease (p<0.001 for MELD), and varied across the stages of ArLD, with the highest score in patients without liver disease (median 65 [30–80]) and the lowest in those with AH (45 [40–80]); however, these differences were not statistically significant (p = 0.7). Alcohol consumption had a stronger influence on EQ-5D outcomes than MELD scores or disease stage. In multivariable analysis, AUDIT remained significantly associated with lower HRQoL scores (p < 0.001), independent of the presence of liver disease or its staging.Conclusion Alcohol consumption is the strongest predictor of impaired HRQoL in patients with ArLD, including those with advanced disease. These findings highlight the importance of targeting alcohol use to improve quality of life in this population.",
  "authors": [
    {
      "affiliations": [
        "Leeds Teaching Hospitals Trust,UK"
      ],
      "name": "Richard Parker"
    },
    {
      "affiliations": [
        "University of Leeds, UK"
      ],
      "name": "Sanjula Shankar"
    },
    {
      "affiliations": [
        "University of Leeds, UK"
      ],
      "name": "Lucy Kirby"
    }
  ],
  "title": "P6 Alcohol use as the primary driver of reduced health-related quality of life in alcohol-related liver disease: a prospective cohort study",
  "uid": "a3f071cd-5381-56c5-9ab3-66a4f8df831a"
}