cACLD in Patients With Alcohol Use Disorder in the Hospital Detoxification Unit (HEP-UHD)

February 17, 2025 updated by: Jordi Sanchez-Delgado, Corporacion Parc Tauli

Detection of Advanced Chronic Liver Disease in Patients With Alcohol Use Disorder in the Hospital Detoxification Unit

The aim of this study is to conduct a quick assessment of potential liver damage caused by chronic alcohol consumption. Taking advantage of the patient's admission to a specialized detoxification unit, several tests will be performed to determine the extent of liver damage through blood tests, ultrasound, and FibroScan

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

There is very little recent data on the prevalence of advance chronic liver disease in high-risk patients, particularly in our region, making studies evaluating this necessary.

In the European clinical practice guidelines (EASL Clinical Practice Guidelines: Management of Alcohol-Related Liver Disease), it is recommended to screen for advance chronic liver disease in high-risk populations such as patients in rehabilitation and detox clinics and heavy drinkers. advance chronic liver disease should be considered in patients presenting with extrahepatic manifestations of alcohol use disorder, such as peripheral symmetric neuropathy, pancreatitis, and cardiomyopathy, among others.

Screening for liver disease in high-risk groups should not only include liver function tests (e.g., gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT], or aspartate aminotransferase [AST]) but also include testing for liver fibrosis (e.g., transient elastography such as FibroScan®), given that advanced liver disease may occur in patients with normal liver profiles.

If any abnormalities are detected in liver profiles or elastography, an abdominal ultrasound should be performed to rule out hepatocellular carcinoma and a complete liver disease study should be carried out to exclude alternative or additional causes of liver damage. Current clinical guidelines (Spanish, European, and American) do not specify which tools to use in each risk subgroup.

The primary objective is to assess the prevalence of advance chronic liver disease measured by transient elastography in patients admitted to the Hospital Detoxification Unit and the acute psychiatric unit with dual pathology and harmful alcohol consumption.

This is a prospective, descriptive, single-center study conducted at Hospital Parc Taulí in Sabadell on patients admitted to the Hospital Detoxification Unit and the psychiatric unit with a diagnosis of dual pathology and harmful alcohol consumption. The study duration will be one year (from June 2024 to June 2025).

We will obtein clinical Variables like date of birth, sex, ethnicity, height, height, medical history (e.g., diagnosis of diabetes, dyslipidemia, hypertension, or underlying psychiatric disorder); Laboratory Variables: ALT, AST, alkaline phosphatase (ALP), GGT, total bilirubin, INR, platelets, glucose, HbA1c, total cholesterol, HDL, LDL, TSH, ferritin, and transferrin saturation. For patients with abnormal liver profiles, a second etiological study will be performed, including ceruloplasmin, copper, alpha-1 antitrypsin, ANA and SLA autoantibodies, immunoglobulins (IgA, IgG, IgM), and protein electrophoresis.

Elastography Variables: FibroScan® values and CAP (Control Attenuation Parameter) to estimate liver stiffness and quantify hepatic fat, respectively.

Radiological Variables: Abdominal ultrasound findings (e.g., homogeneous or heterogeneous liver, presence of steatosis, nodular liver borders, splenomegaly, recanalization of the paraumbilical vein, collateral circulation, portal velocity, hepatic nodules). Endoscopic Variables: For patients diagnosed with advance chronic liver disease, esophagogastroduodenoscopy will be performed to rule out esophageal varices if criteria are met. Serological Variables for Fibrosis Estimation: LiverRisk score, APRI, FIB-4, Forns index, AAR (AST to ALT ratio).

Regardless of liver profile abnormalities, an abdominal ultrasound will be requested to evaluate parenchymal changes and other indirect signs of liver disease and/or portal hypertension. Additional data collected by psychiatry will include the patient's date of birth, years of alcohol consumption, grams of alcohol/day measured in Standard Drink Units (SDUs), weight, height, relevant cardiovascular diseases (hypertension, diabetes, dyslipidemia), and underlying psychiatric disorders.

A hepatology consultation will be requested, and FibroScan® will be performed during hospitalization. All fibrosis scores (LiverRisk score, APRI, FIB-4, Forns, and AAR) will be calculated using demographic and laboratory data.

If liver profile abnormalities are detected upon admission, a complete second etiological study will be requested.

All patients, regardless of whether they have advanced chronic liver disease or not, will be evaluated by a hepatologist who will provide information about the results of the diagnostic tests performed and the potential harmful effects of alcohol on the liver and overall health. This will reinforce the information provided by the psychiatrist in an effort to encourage the patient to cease alcohol consumption.

If the patient presents advance chronic liver disease (FibroScan® >8 KPa) or analytical, elastographic, or radiological evidence suggestive of cirrhosis will be referred to hepatology outpatient clinics for further evaluation and follow-up. Patients without advance chronic liver disease findings will be referred to primary care by their attending psychiatrist for follow-up.

Study Type

Observational

Enrollment (Estimated)

150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Barcelona
      • Sabadell, Barcelona, Spain, 08208
        • Consorci Corporació Sanitària Parc Taulí

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Patients admitted to the detoxification unit for alcohol use disorder or de psychiatry unit for dual pathology with harmful alcohol consumption

Description

Inclusion Criteria:

  • Patients admitted to the detoxification unit for alcohol use disorder
  • Patients admitted to the psychiatry unit for dual pathology with harmful alcohol consumption (> 30 g/day in men (3 standard drinks) and > 20 g/day in women (2 standard drinks))

Exclusion Criteria:

  • Refusal to undergo additional tests (blood analysis, ultrasound, and FibroScan)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients with excessive alcohol consumption admitted to the hospital detoxification unit
The intervention performed on patients who have been electively admitted to the hospital detoxification unit consists of diagnostic tests to assess potential liver damage secondary to alcohol consumption. These are usually young patients with very high alcohol intake who, under normal circumstances, would need to be evaluated on an outpatient basis. Since the potential prevalence of advanced liver disease is expected to be higher in this subgroup of patients, the hospital stay is utilized to carry out all these tests quickly. The tests performed will include a general blood analysis to evaluate liver and kidney function, an assessment of the prevalence of metabolic diseases such as obesity, hypertension, or diabetes, an abdominal ultrasound, and elastography to assess liver stiffness.
Diagnostic test: Screening of compensated advance chronic liver disease

The tests performed will include a general blood analysis to evaluate liver and kidney function, an assessment of the prevalence of metabolic diseases such as obesity, hypertension, or diabetes, an abdominal ultrasound, and elastography to assess liver stiffness.

Another intervention to be studied is whether the request for diagnostic tests to evaluate liver disease, as well as the visit of the hepatologist during hospitalization in the detoxification unit, influences subsequent alcohol abstinence. To this end, abstinence will be assessed six months after admission to the alcohol detoxification unit and compared with a retrospective cohort of patients admitted to the detoxification unit one year ago, in whom no liver disease evaluation was conducted neither information of potencial liver damage was offered by hepatologist and the intervention was carried out only by the psychiatrists responsible for the unit.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Prevalence of advanced chronic liver disease in patients who are electively admitted to the hospital alcohol detoxification unit
Time Frame: 5 days
Prevalence of pathological findings in the fibroscan that suggest compensated chronic liver disease
5 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Corporacion Parc Tauli

Investigators

  • Principal Investigator: Jordi Sánchez Delgado, MD. PhD, Consorci Corporació Sanitària Parc Taulí

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 6, 2024

Primary Completion (Actual)

March 12, 2024

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

January 13, 2025

First Submitted That Met QC Criteria

February 17, 2025

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

February 17, 2025

Last Verified

February 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024/5057 (Other Identifier: CEIM Parc Tauli)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Information about the project will be shared if another center is interested in participating and conducting a multicenter study

IPD Sharing Time Frame

The information will be available at the end of the study in January 2026

IPD Sharing Access Criteria

Other researchers will have the opportunity to contact the principal investigator of the study and discuss any rellevant study information

IPD Sharing Supporting Information Type

  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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