Trajectory of self-reported alcohol consumption leading up to the initial diagnosis of alcohol-related cirrhosis: a retrospective study.

AIM: To assess the patterns of self-reported alcohol consumption leading to the diagnosis of alcohol-related liver cirrhosis and identify potential discrepancies or underreporting. METHODS: This retrospective study included 4332 adult patients (64.9% male) diagnosed with alcohol-related cirrhosis (ICD-10 codes: K70.30, K70.31) from January 2012 to April 2024. Self-reported alcohol use was evaluated from patient records at the 10 most recent clinical encounters before diagnosis. Responses ("yes," "not currently," "no," "never," "defer") were analyzed longitudinally for patterns and shifts. RESULTS: Active drinking ("yes") decreased from 59.7% at a median of 388 days before diagnosis to 41.9% at 8 days before. Conversely, responses indicating recent cessation ("not currently") increased from 16.7% to 41.3%. Patients with consistently negative responses represented 9.5% of the sample. Most patients (81.9%) demonstrated variable or fluctuating responses over time. CONCLUSION: The observed shift toward reporting abstinence approaching diagnosis is consistent with potential underreporting in high-stakes clinical settings. Objective biomarkers should be integrated into clinical practice to improve diagnostic accuracy and patient management in alcohol-related liver disease.