OBJECTIVE: Knowledge on the prognosis among patients with cirrhosis is mainly based on clinical trials with selected patient groups as well as population-based register studies with suboptimal diagnostic reliability. The aim of the study was to describe incidence, etiology, and mortality of well-validated cirrhotic cases in a population-based cohort at Funen (population 470,000) between 1996 and 2006. MATERIALS AND METHODS: A population-based cohort study with case identification from discharge diagnosis followed by manual validation of patient records with inclusion of cases that fulfilled predefined diagnostic criteria. RESULTS: 4010 possible cases were identified. 1369 patients were included, 67% males, mean age 56.4 years, 75% had cirrhotic complications at entry. Mean follow-up was 3.6 years with a total of 4976 years of follow-up. The incidence was 33/100,000 person-years (95% confidence interval CI 28-40). Stratified for age and sex, the incidence was twice as high for men compared with women in all age groups. The five-year mortality was 62% (95% CI 59-65). A multivariate analysis showed a high mortality associated with male gender (HR 1.24, 95% CI 1.08-1.42), ages above 70 years (HR 2.01 95% CI 1.65-2.47) compared with ages 50-59 years, complications present at diagnosis (HR 1.28, 95% CI 1.09-1.50) and etiology of alcoholic disease or cryptogenic cirrhosis (HR 2.38, 95% CI 1.22-4.67 and 2.26, 95% CI 1.13-4.53). CONCLUSIONS: Incidence of cirrhosis is higher among men than among women. High age, male gender, alcoholic cirrhosis, cryptogenic cirrhosis, and complications at the time of diagnosis increased mortality.
OBJECTIVE: Knowledge on the prognosis among patients with cirrhosis is mainly based on clinical trials with selected patient groups as well as population-based register studies with suboptimal diagnostic reliability. The aim of the study was to describe incidence, etiology, and mortality of well-validated cirrhotic cases in a population-based cohort at Funen (population 470,000) between 1996 and 2006. MATERIALS AND METHODS: A population-based cohort study with case identification from discharge diagnosis followed by manual validation of patient records with inclusion of cases that fulfilled predefined diagnostic criteria. RESULTS: 4010 possible cases were identified. 1369 patients were included, 67% males, mean age 56.4 years, 75% had cirrhotic complications at entry. Mean follow-up was 3.6 years with a total of 4976 years of follow-up. The incidence was 33/100,000 person-years (95% confidence interval CI 28-40). Stratified for age and sex, the incidence was twice as high for men compared with women in all age groups. The five-year mortality was 62% (95% CI 59-65). A multivariate analysis showed a high mortality associated with male gender (HR 1.24, 95% CI 1.08-1.42), ages above 70 years (HR 2.01 95% CI 1.65-2.47) compared with ages 50-59 years, complications present at diagnosis (HR 1.28, 95% CI 1.09-1.50) and etiology of alcoholic disease or cryptogenic cirrhosis (HR 2.38, 95% CI 1.22-4.67 and 2.26, 95% CI 1.13-4.53). CONCLUSIONS: Incidence of cirrhosis is higher among men than among women. High age, male gender, alcoholic cirrhosis, cryptogenic cirrhosis, and complications at the time of diagnosis increased mortality.
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Authors: Lawrence Mj Best; Jeffrey Leung; Suzanne C Freeman; Alex J Sutton; Nicola J Cooper; Elisabeth Jane Milne; Maxine Cowlin; Anna Payne; Dana Walshaw; Douglas Thorburn; Chavdar S Pavlov; Brian R Davidson; Emmanuel Tsochatzis; Norman R Williams; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2020-01-16
Authors: Bjørn S Madsen; Maja Thiele; Sönke Detlefsen; Mia D Sørensen; Maria Kjaergaard; Linda S Møller; Ditlev N Rasmussen; Anders Schlosser; Uffe Holmskov; Jonel Trebicka; Grith L Sorensen; Aleksander Krag Journal: Liver Int Date: 2020-05-10 Impact factor: 5.828