Effect of abstinence from alcohol on survival of patients with alcoholic cirrhosis: A systematic review and meta‐analysis

AIM: To address the questions of whether abstinence improves survival of patients with alcoholic cirrhosis (AC) and how long it takes for the effect to be significant. METHODS: A systematic review and a meta-analysis are performed to assess the effect of abstinence on the survival of patients with AC. RESULTS: Seven cohort studies involving 1235 patients with AC were included. No differences were found in 0.5-year survival (hazard ratio [HR] = 0.48, 95% confidence interval [CI] = 0.23-1.03, P = 0.06) and 1-year survival (HR = 0.58, 95% CI = 0.32-1.03, P = 0.06) between the abstinent and continue drinking groups. However, differences were found in 1.5-year survival (HR = 0.51, 95% CI = 0.33-0.81, P = 0.004), 2-year survival (HR = 0.55, 95% CI = 0.38-0.78, P = 0.0008), 2.5-year survival (HR = 0.54, 95% CI = 0.38-0.77, P = 0.0005), 3-year survival (HR = 0.54, 95% CI = 0.40-0.74, P = 0.0001), 3.5-year survival (HR = 0.56, 95% CI = 0.44-0.73, P < 0.00001), 4-year survival (HR = 0.60, 95% CI = 0.48-0.73, P < 0.00001), 4.5-year survival (HR = 0.61, 95% CI = 0.49-0.76, P < 0.0001) and 5-year survival (HR = 0.63, 95% CI = 0.52-0.76, P < 0.00001) between the two groups. CONCLUSION: Alcohol abstinence does improve the survival of patients with AC, and it takes at least 1.5 years of alcohol abstinence before a statistically significant difference in survival can be observed between the abstinent and the continue drinking groups.