Lewis, E

Mannix, K

O'Hare, G

Owens, L

Richardson, L

Richardson, P

Thompson, A

University of Liverpool Repository

ILC2016-RS-4224Non-invasive markers of liver fibrosisTHE UTILITY OF FIBROELASTOGRAPHY TO DETECT ALCOHOL-RELATED LIVER DISEASE IN A NURSE-LEDOUTPATIENT ALCOHOL TREATMENT CLINICLynn Owens* 1, 2, Andrew  Thompson1, Kevin Mannix2, Elaine Lewis2, Gill O'Hare2, Laura Richardson2, Paul Richardson21Wolfson Centre for Personalised Medicine, UNIVERSITY OF LIVERPOOL, 2Hepatology, Royal Liverpool & BroadgreenUniversity Hospital Trust, Liverpool, United KingdomCorresponding author’s email: lynno@liv.ac.ukDo you want to apply for a Young Investigator Bursary?: NoDo you want to apply to the YI Award?: NoBackground and Aims: In the last 10yrs the UK has experienced a 62% increase in liver disease with 1/3 of all deathsfrom liver disease attributed to alcohol. It is Important to highlight that all of these deaths are preventable. However,alcohol-related liver disease (ALD) is often not diagnosed until damage is irreversible. Therefore, we need to developsystems of care that increase the detection of ALD at the earliest stages. We suggest that fibroelastography may be auseful tool in a nurse-led outpatient Alcohol Treatment Clinic (ATC), to maximise early detection of ALD in a high riskpopulation and affording opportunities to intervene and prevent subsequent mortality and death. Aim: To determine theclinical utility of performing fibroelastography in an ATC to identify the presence of liver fibrosis.Methods: An observational prospective clinical audit was performed. Primary outcome measures were; the number ofindividuals where fibrosis was detected in the a) absence of abnormal liver biochemistry, b) presence of abnormal liverbiochemistry defined as a raised ALT or GGT ≥3x normal.  Setting: Acute hospital nurse-led outpatient AlcoholTreatment Clinic. Participants: 296 patients with alcohol-use disorders and no previous history of cirrhosis.Results: Of the 296 patients; 136 female; 160 male; with a mean age of 47 years (SD = 10). Median alcohol consumptionwas 24 units per day (IQR = 15). Eightynine (30.1%) patients showed no evidence for abnormal liver biochemistry ofthese 55 (61.8%) had no evidence of fibrosis (<6.5kpa), 17 (19.1%) showed F1/2 fibrosis (≥6.5 <11kpa), 17 (19.1%)showed F3/4 fibrosis (≥11kpa) meeting criteria for referral to hepatology. In total 34 (38.2%) patients had an abnormalfibroscan with no significant liver biochemistry. Twohundred and seven (69.9%) patients had abnormal liver biochemistryof which 72 (34.7%) had no evidence of fibrosis (<6,5kpa), 51 (24.6) showed F1/2 fibrosis (≥6.5 <11kpa) and 84 (40.5%)showed F3/4 fibrosis (≥11kpa) meeting criteria for referral to hepatology.  Conclusions: Nurse-led ATC setting is a valuable and effective setting for the early detection of ALD utilisingfibroelastography. The procedure is quick and patients value the addition of an objective measure forcomparisons over time. Most important is that significant fibrosis was detected in over one third of patientswho might not otherwise have been identified until much later in the natural history of liver damage and failure.Disclosure of Interest: None Declared

THE UTILITY OF FIBROELASTOGRAPHY TO DETECT ALCOHOL-RELATED LIVER DISEASE IN A NURSE-LED OUTPATIENT ALCOHOL TREATMENT CLINIC

L. Owens

A. Thompson

K. Mannix

E. Lewis

G. O’Hare

L. Richardson

P. Richardson

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Journal of Hepatology

The Utility of Fibroelastography to Detect Alcohol-Related Liver Disease in a Nurse-Led Outpatient Alcohol Treatment Clinic

THE UTILITY OF FIBROELASTOGRAPHY TO DETECT ALCOHOL-RELATED LIVER DISEASE IN A NURSE-LED OUTPATIENT ALCOHOL TREATMENT CLINIC

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