Liver-Related And Other-Cause Mortality Risk In Excessive Drinkers: Analysis Of Data From The UK Biobank

Background and AimsHigh alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts. Approach and ResultsInformation was obtained from the UK Biobank on approximately 500,000 participants aged 40-70 years at baseline assessment in 2006-2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported taking [≥]80 g/day or [≥]50g/day, respectively, were used in survival analysis. Compared to all other participants, their mortality HRs were 9.40 (95% CI 7.00-12.64) for any liver disease (ICD-10 K70-K76), 2.02 (1.89-2.17) for all causes, 1.89 (1.69-2.12) for any cancer (C00-C99), and 1.87 (1.61-2.17) for any circulatory disease (I00-I99). Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake, diagnosed alcohol dependence (ICD-10 F10.2), and current smoking at assessment. ConclusionsPeople with chronic excessive alcohol intake experience decreased average survival but there is substantial variation in their mortality, with liver abnormality and alcohol dependence each associated with worse prognosis. Clinically, patients with these risk factors as well as high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality.