P16 Experience of addiction care team embedded transient elastography in inpatients with harmful alcohol use

<h3>Introduction</h3> Transient elastography (TE) is a non-invasive means of identifying liver fibrosis and cirrhosis. National Institute for Health and Care Excellence (NICE) guidelines recommend TE in adults drinking alcohol at harmful levels, defined as more than 50 units per week in men and 35 units per week in women. Whilst many community alcohol services employ TE, its value in inpatient settings is unknown. <h3>Aim</h3> Evaluate the identification of liver disease by TE performed by an inpatient Addiction Care Team (ACT). <h3>Methods</h3> Retrospective analysis of patients that underwent ACT led TE in an inpatient setting between June 2022 and April 2023. All adult inpatients were eligible if they met the criteria for harmful alcohol use, and standard TE exclusion criteria applied. Patients were either elective admissions to the Addiction Clinical Care Suite (ACCS) for alcohol detoxification, or unplanned admissions referred to the ACT. Most ACT referrals are admissions with a primary alcohol related problem (e.g. alcohol related pancreatitis) or a medical issue complicated by alcohol withdrawal (e.g. pneumonia in an alcohol dependent person). The ACCS is an eleven-bed unit providing specialist addictions care for patients with complex social, medical, and psychiatric needs. Patients are referred to the unit from community drug and alcohol services across London for medically assisted withdrawal from a range of substances. It is currently the only inpatient addictions unit in London embedded within an acute NHS trust. Valid TE measurements were collected from fasting patients via FibroScan® (Echosens; Paris, France) at least 24 hours after admission. Liver stiffness was interpreted as; normal if &lt;8kPa, significant fibrosis if 8–15.9kPa, and possible cirrhosis if ≥16kPa. <h3>Results</h3> 166 patients had valid TE measurements, of which 122 (73.5%) were men and 44 (26.5%) were women. The mean age was 49.3±11.8, the mean self-reported alcohol units consumed per week was 197±14, and the mean years of self-reported harmful drinking was 29±14 (n=98). Of 166 scans, 103 (62.0%) were normal, 31 (18.7%) showed moderate fibrosis, and 32 (19.3%) showed possible cirrhosis. The breakdown of results by type of admission is shown in table 1. <h3>Discussion</h3> 38% of inpatients undergoing ACT led TE for liver disease assessment had significant fibrosis or cirrhosis. Opportunistic screening conducted by addiction trained specialist nurses may be a valuable intervention to identify liver disease in a high-risk population and could potentially affect drinking behaviour.