All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study

Fleming, Kate M.; Aithal, Guruprasad P.; Card, Tim R.; West, Joe

Abstract

Background: Mortality due to cirrhosis has tripled over the last 30 years in the UK. However, we lack adequate, contemporary, population-based estimates of the excess mortality patients who are at risk compared with the general population.
Aim: To determine the overall survival in patients with cirrhosis compared with the general population taking into account the effects of severity and aetiology of disease and comorbidity.
Methods: In a cohort study, we identified 4537 people with cirrhosis and a control cohort of 44 403 patients, matched by age, sex and general practice from the UK General Practice Research Database between June 1987 and April 2002.
Results: Patients with compensated cirrhosis had a nearly five-fold [hazard ratio (HR) 4.7, 95% confidence interval (CI) 4.4–5.0] increased risk of death, while those with decompensated cirrhosis had a near 10-fold (HR 9.7, 95% CI 8.9–10.6) increased risk compared with the general population. Alcoholic cirrhosis conferred a worse prognosis than non-alcohol-related cirrhosis both in the first year following diagnosis and subsequently.
Conclusion: Having a diagnosis of cirrhosis confers a substantial increased mortality risk compared with the general population, even for those with compensated disease, with 5-year survival between that seen for breast and colorectal cancer.

Citation

Fleming, K. M., Aithal, G. P., Card, T. R., & West, J. (2012). All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver International, 32(1), https://doi.org/10.1111/j.1478-3231.2011.02517.x

• Journal Article Type: Article
• Acceptance Date: Mar 2, 2011
• Online Publication Date: Apr 6, 2011
• Publication Date: Jan 3, 2012
• Deposit Date: Aug 24, 2017
• Publicly Available Date: Aug 24, 2017
• Journal: Liver International
• Print ISSN: 1478-3223
• Electronic ISSN: 1478-3231
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 1
• DOI: https://doi.org/10.1111/j.1478-3231.2011.02517.x
• Public URL: https://nottingham-repository.worktribe.com/output/709165
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02517.x/abstract