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Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea

BACKGROUND: Liver cirrhosis has become a heavy burden not only for patients, but also for our society. However, little is known about the recent changes in clinical outcomes and characteristics of patients with cirrhosis-related complications in Korea. Therefore, we aimed to evaluate changes in char...

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Autores principales: Jang, Won Young, Chung, Woo Jin, Jang, Byoung Kuk, Hwang, Jae Seok, Lee, Heon Ju, Hwang, Moon Joo, Kweon, Young Oh, Tak, Won Young, Park, Soo Young, Lee, Su Hyun, Lee, Chang Hyeong, Kim, Byung Seok, Kim, Si Hye, Suh, Jeong Ill, Park, Jun Gi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384901/
https://www.ncbi.nlm.nih.gov/pubmed/32715667
http://dx.doi.org/10.3346/jkms.2020.35.e233
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author Jang, Won Young
Chung, Woo Jin
Jang, Byoung Kuk
Hwang, Jae Seok
Lee, Heon Ju
Hwang, Moon Joo
Kweon, Young Oh
Tak, Won Young
Park, Soo Young
Lee, Su Hyun
Lee, Chang Hyeong
Kim, Byung Seok
Kim, Si Hye
Suh, Jeong Ill
Park, Jun Gi
author_facet Jang, Won Young
Chung, Woo Jin
Jang, Byoung Kuk
Hwang, Jae Seok
Lee, Heon Ju
Hwang, Moon Joo
Kweon, Young Oh
Tak, Won Young
Park, Soo Young
Lee, Su Hyun
Lee, Chang Hyeong
Kim, Byung Seok
Kim, Si Hye
Suh, Jeong Ill
Park, Jun Gi
author_sort Jang, Won Young
collection PubMed
description BACKGROUND: Liver cirrhosis has become a heavy burden not only for patients, but also for our society. However, little is known about the recent changes in clinical outcomes and characteristics of patients with cirrhosis-related complications in Korea. Therefore, we aimed to evaluate changes in characteristics of patients with liver cirrhosis in Daegu-Gyeongbuk province in Korea over the past 15 years. METHODS: We retrospectively reviewed the medical records of 15,716 liver cirrhotic patients from 5 university hospitals in Daegu-Gyeongbuk province from 2000 to 2014. The Korean Standard Classification of Diseases-6 code associated with cirrhosis was investigated through medical records and classified according to the year of first visit. RESULTS: A total of 15,716 patients was diagnosed with cirrhosis. A number of patients newly diagnosed with cirrhosis has decreased each year. In 2000, patients were most likely to be diagnosed with hepatitis B virus (HBV) cirrhosis, followed by alcoholic cirrhosis. There was a significant decrease in HBV (P < 0.001), but alcohol, hepatitis C virus (HCV), and non-alcoholic fatty liver disease (NAFLD) showed a significant increase during the study period (alcohol, P = 0.036; HCV, P = 0.001; NAFLD, P = 0.001). At the time of initial diagnosis, the ratio of Child-Turcotte-Pugh (CTP) class A gradually increased from 23.1% to 32.9% (P < 0.001). The most common cause of liver-related hospitalization in 2000 was hepatocellular carcinoma (HCC) (25.5%); in 2014, gastrointestinal bleeding with esophageal and gastric varices (21.4%) was the most common cause. Cases of hospitalization with liver-related complication represented 76.4% of all cases in 2000 but 70.9% in 2014. Incidence rate of HCC has recently increased. In addition, HCC-free survival was significantly lower in CTP class A than in classes B and C. Finally, there was significant difference in HCC occurrence according to causes (P < 0.001). HBV and HCV cirrhosis had lower HCC-free survival than alcoholic and NAFLD cirrhosis. CONCLUSION: In recent years, the overall number of cirrhosis patients has decreased. This study confirmed the recent trend in decrease of cirrhosis, especially of cirrhosis due to HBV, and the increase of HCV, alcoholic and NAFLD cirrhosis. Targeted screening for at-risk patients will facilitate early detection of liver diseases allowing effective intervention and may have decreased the development of cirrhosis and its complications.
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spelling pubmed-73849012020-07-29 Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea Jang, Won Young Chung, Woo Jin Jang, Byoung Kuk Hwang, Jae Seok Lee, Heon Ju Hwang, Moon Joo Kweon, Young Oh Tak, Won Young Park, Soo Young Lee, Su Hyun Lee, Chang Hyeong Kim, Byung Seok Kim, Si Hye Suh, Jeong Ill Park, Jun Gi J Korean Med Sci Original Article BACKGROUND: Liver cirrhosis has become a heavy burden not only for patients, but also for our society. However, little is known about the recent changes in clinical outcomes and characteristics of patients with cirrhosis-related complications in Korea. Therefore, we aimed to evaluate changes in characteristics of patients with liver cirrhosis in Daegu-Gyeongbuk province in Korea over the past 15 years. METHODS: We retrospectively reviewed the medical records of 15,716 liver cirrhotic patients from 5 university hospitals in Daegu-Gyeongbuk province from 2000 to 2014. The Korean Standard Classification of Diseases-6 code associated with cirrhosis was investigated through medical records and classified according to the year of first visit. RESULTS: A total of 15,716 patients was diagnosed with cirrhosis. A number of patients newly diagnosed with cirrhosis has decreased each year. In 2000, patients were most likely to be diagnosed with hepatitis B virus (HBV) cirrhosis, followed by alcoholic cirrhosis. There was a significant decrease in HBV (P < 0.001), but alcohol, hepatitis C virus (HCV), and non-alcoholic fatty liver disease (NAFLD) showed a significant increase during the study period (alcohol, P = 0.036; HCV, P = 0.001; NAFLD, P = 0.001). At the time of initial diagnosis, the ratio of Child-Turcotte-Pugh (CTP) class A gradually increased from 23.1% to 32.9% (P < 0.001). The most common cause of liver-related hospitalization in 2000 was hepatocellular carcinoma (HCC) (25.5%); in 2014, gastrointestinal bleeding with esophageal and gastric varices (21.4%) was the most common cause. Cases of hospitalization with liver-related complication represented 76.4% of all cases in 2000 but 70.9% in 2014. Incidence rate of HCC has recently increased. In addition, HCC-free survival was significantly lower in CTP class A than in classes B and C. Finally, there was significant difference in HCC occurrence according to causes (P < 0.001). HBV and HCV cirrhosis had lower HCC-free survival than alcoholic and NAFLD cirrhosis. CONCLUSION: In recent years, the overall number of cirrhosis patients has decreased. This study confirmed the recent trend in decrease of cirrhosis, especially of cirrhosis due to HBV, and the increase of HCV, alcoholic and NAFLD cirrhosis. Targeted screening for at-risk patients will facilitate early detection of liver diseases allowing effective intervention and may have decreased the development of cirrhosis and its complications. The Korean Academy of Medical Sciences 2020-06-19 /pmc/articles/PMC7384901/ /pubmed/32715667 http://dx.doi.org/10.3346/jkms.2020.35.e233 Text en © 2020 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jang, Won Young
Chung, Woo Jin
Jang, Byoung Kuk
Hwang, Jae Seok
Lee, Heon Ju
Hwang, Moon Joo
Kweon, Young Oh
Tak, Won Young
Park, Soo Young
Lee, Su Hyun
Lee, Chang Hyeong
Kim, Byung Seok
Kim, Si Hye
Suh, Jeong Ill
Park, Jun Gi
Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea
title Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea
title_full Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea
title_fullStr Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea
title_full_unstemmed Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea
title_short Changes in Characteristics of Patients with Liver Cirrhosis Visiting a Tertiary Hospital over 15 Years: a Retrospective Multi-Center Study in Korea
title_sort changes in characteristics of patients with liver cirrhosis visiting a tertiary hospital over 15 years: a retrospective multi-center study in korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384901/
https://www.ncbi.nlm.nih.gov/pubmed/32715667
http://dx.doi.org/10.3346/jkms.2020.35.e233
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