SONIA GRAN SONIA.GRAN@NOTTINGHAM.AC.UK
Associate Professor
1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
Ratib, Sonia; Fleming, Kate M.; Crooks, Colin J.; Aithal, Guru P.; West, Joe
Authors
Kate M. Fleming
Dr COLIN CROOKS Colin.Crooks@nottingham.ac.uk
Clinical Associate Professor
Guru P. Aithal
JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology
Abstract
BACKGROUND & AIMS:
Large, population-based studies that have included the full spectrum of cirrhosis estimating survival, taking into account time-at-risk are lacking. We aimed to report 1- and 5-year average survival rates for people with cirrhosis to be used in a clinical and healthcare policy setting.
METHODS:
We used the Clinical Practice Research Datalink and linked English Hospital Episode Statistics to identify adult cases of cirrhosis from January 1998 to December 2009. We estimated 1- and 5-year survival according to whether time-at-risk was ambulatory or followed an emergency hospital admission related to liver disease, stratified by age, sex, and aetiology to be used in a clinical setting. We used a multivariate Cox-proportional hazards model with a time-varying variable, adjusted for Baveno IV stage of cirrhosis at diagnosis, age, aetiology, and sex.
RESULTS:
We identified 5118 incident cases. Average survival probabilities at 1- and 5-years were 0.84 (95% CI 0.83-0.86) and 0.66 (95% CI 0.63-0.68) for the ambulatory group and 0.55 (95% CI 0.53-0.57) and 0.31 (95% CI 0.29-0.33) following hospitalisation, respectively. A hospital admission at diagnosis or subsequently for liver disease substantially impaired prognosis independent of stage of cirrhosis (HR=2.78, 95% CI 2.53, 3.06).
CONCLUSIONS:
Emergency hospitalisation for liver disease heralds a downturn in a patient's outlook independent of their stage of cirrhosis. Our results provide population-based clinically translatable estimates of prognosis for the purposes of healthcare delivery and planning and communication to patients.
Citation
Ratib, S., Fleming, K. M., Crooks, C. J., Aithal, G. P., & West, J. (2014). 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study. Journal of Hepatology, 60(2), https://doi.org/10.1016/j.jhep.2013.09.027
Journal Article Type | Article |
---|---|
Publication Date | Feb 1, 2014 |
Deposit Date | Apr 1, 2016 |
Publicly Available Date | Apr 1, 2016 |
Journal | Journal of Hepatology |
Print ISSN | 0168-8278 |
Electronic ISSN | 1600-0641 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 60 |
Issue | 2 |
DOI | https://doi.org/10.1016/j.jhep.2013.09.027 |
Keywords | cirrhosis, survival, aetiology, population-based |
Public URL | https://nottingham-repository.worktribe.com/output/720751 |
Publisher URL | http://www.sciencedirect.com/science/article/pii/S0168827813006910 |
Files
Ratib_Manuscript_JHepatology.pdf
(675 Kb)
PDF
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