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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

SONIA GRAN SONIA.GRAN@NOTTINGHAM.AC.UK
Assistant Professor

Kate M. Fleming

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), doi: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 http://eprints.nottingham.ac.uk/id/eprint/32563
Publisher URL http://www.sciencedirect.com/science/article/pii/S0168827813006910
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Ratib_Manuscript_JHepatology.pdf (675 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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