Patterns and Outcomes of Alcoholic Liver Disease (ALD) in Oman: A Retrospective Study in a Culturally Conservative Context
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patient Selection and Definitions
2.3. Data Collection
- Demographic information: age, sex, nationality, and known comorbidities (e.g., diabetes, hypertension, viral hepatitis, and metabolic syndrome).
- Alcohol history: pattern, frequency, and duration of alcohol consumption based on available clinical notes and social history.
- Clinical presentation at index admission: symptoms such as jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding, and signs of decompensated liver disease.
- Laboratory parameters: liver function tests (AST, ALT, total and direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase), coagulation profile (INR), renal function (creatinine, urea), serum albumin, complete blood count, and markers of synthetic liver function.
- Radiological findings: abdominal ultrasound and/or CT imaging reports were reviewed to assess for hepatomegaly, liver echotexture, splenomegaly, ascites, and portosystemic collaterals.
- Portal hypertension: this was defined using a combination of clinical, laboratory, imaging, and endoscopic criteria; these included the presence of splenomegaly, thrombocytopenia (platelet count <150,000/μL), ascites, or portosystemic collaterals detected on imaging (ultrasound or CT), as well as esophageal or gastric varices documented via upper gastrointestinal endoscopy.
- Mortality data: these were retrieved from hospital records and follow-up visits, including the date and cause of death when available.
2.4. Complication Assessment
2.5. Statistical Analysis
3. Results
3.1. Demographic Characteristics and ALD Manifestations
3.2. Clinical Presentation Across ALD Stages
3.3. Complications in ALD Patients: Initial Presentation and Overall Course
3.4. Mortality and Health Status
3.5. Causes of Death
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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ALD Stage | Total, n (%) | Age < 50, n/N (%) | Age ≥ 50, n/ (%) | p-Value |
---|---|---|---|---|
Fatty liver | 29 (34.5%) | 17/38 (44.7%) | 12/46 (26.1%) | 0.08 |
Alcoholic hepatitis | 17 (20.2%) | 10/38 (26.3%) | 7/46 (15.2%) | 0.21 |
Cirrhosis | 34 (40.5%) | 11/38 (28.9%) | 23/46 (50.0%) | 0.048 * |
HCC | 4 (4.8%) | 0/38 (0.0%) | 4/46 (8.7%) | 0.10 |
Presentation | Fatty Liver (n = 29), n (%) | Alcoholic Hepatitis (n = 17), n (%) | Cirrhosis (n = 34), n (%) | p-Value |
---|---|---|---|---|
Abdominal pain | 13 (44.8%) | 7 (41.2%) | 15 (44.1%) | 0.93 |
UGIB | 3 (10.3%) | 5 (29.4%) | 10 (29.4%) | 0.21 |
Abdominal distention | 0 (0.0%) | 1 (5.9%) | 5 (14.7%) | 0.030 * |
Jaundice | 0 (0.0%) | 8 (47.1%) | 3 (8.8%) | 0.001 * |
Thrombocytopenia | 0 (0.0%) | 1 (5.9%) | 1 (2.9%) | 0.61 |
Trauma (fall) | 0 (0.0%) | 3 (17.6%) | 1 (2.9%) | 0.17 |
Complication | Fatty Liver (n = 29) | Alcoholic Hepatitis (n = 17) | Cirrhosis (n = 34) | p-Value |
---|---|---|---|---|
No complication (first) | 8 (27.6%) | 6 (35.3%) | 2 (5.9%) | 0.019 * |
Ascites | 0 (0.0%) → 0 (0.0%) | 3 (17.6%) → 9 (52.9%) | 11 (32.4%) → 26 (76.5%) | <0.001 * |
UGIB | 2 (6.9%) → 6 (20.7%) | 2 (11.8%) → 5 (29.4%) | 15 (44.1%) → 20 (58.8%) | <0.001 * |
HE | 0 (0.0%) → 0 (0.0%) | 0 (0.0%) → 2 (11.8%) | 1 (2.9%) → 10 (29.4%) | 0.002 * |
Portal hypertension | 0 (0.0%) → 0 (0.0%) | 0 (0.0%) → 6 (35.3%) | 0 (0.0%) → 28 (82.4%) | <0.001 * |
SBP | — → 0 (0.0%) | — → 2 (11.8%) | — → 9 (26.5%) | 0.064 |
HCC | 0 (0.0%) → 0 (0.0%) | 1 (5.9%) → 1 (5.9%) | 3 (8.8%) → 3 (8.8%) | 0.072 |
Outcome | Fatty Liver (n = 29), n (%) | Alcoholic Hepatitis (n = 17), n (%) | Cirrhosis (n = 34), n (%) | p-Value |
---|---|---|---|---|
Alive | 26 (89.7%) | 10 (58.8%) | 15 (44.1%) | <0.001 * |
Deceased | 3 (10.3%) | 6 (35.3%) | 15 (44.1%) | |
Unknown † | 0 (0.0%) | 1 (5.9%) | 4 (11.8%) |
Cause | Fatty Liver (n = 3), n (%) | Alcoholic Hepatitis (n = 6), n (%) | Cirrhosis (n = 15), n (%) | p-Value |
---|---|---|---|---|
Sepsis | 1 (33.3%) | 2 (33.3%) | 6 (40.0%) | 0.95 |
Massive UGIB | 1 (33.3%) | 2 (33.3%) | 4 (26.7%) | 0.89 |
HRS | 0 (0.0%) | 0 (0.0%) | 2 (13.3%) | 0.47 |
Perforated PUD | 0 (0.0%) | 0 (0.0%) | 1 (6.7%) | 0.99 |
Trauma (fall) | 0 (0.0%) | 1 (16.7%) | 0 (0.0%) | 0.18 |
Unknown | 1 (33.3%) | 1 (16.7%) | 2 (13.3%) | — |
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Al-Busafi, S.A.; Al Baluki, T.A.; Alwassief, A. Patterns and Outcomes of Alcoholic Liver Disease (ALD) in Oman: A Retrospective Study in a Culturally Conservative Context. Livers 2025, 5, 38. https://doi.org/10.3390/livers5030038
Al-Busafi SA, Al Baluki TA, Alwassief A. Patterns and Outcomes of Alcoholic Liver Disease (ALD) in Oman: A Retrospective Study in a Culturally Conservative Context. Livers. 2025; 5(3):38. https://doi.org/10.3390/livers5030038
Chicago/Turabian StyleAl-Busafi, Said A., Thuwiba A. Al Baluki, and Ahmed Alwassief. 2025. "Patterns and Outcomes of Alcoholic Liver Disease (ALD) in Oman: A Retrospective Study in a Culturally Conservative Context" Livers 5, no. 3: 38. https://doi.org/10.3390/livers5030038
APA StyleAl-Busafi, S. A., Al Baluki, T. A., & Alwassief, A. (2025). Patterns and Outcomes of Alcoholic Liver Disease (ALD) in Oman: A Retrospective Study in a Culturally Conservative Context. Livers, 5(3), 38. https://doi.org/10.3390/livers5030038