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Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
BACKGROUND/AIMS: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. METHODS: Cirrhosis patients...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Association for the Study of the Liver
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820216/ https://www.ncbi.nlm.nih.gov/pubmed/33317256 http://dx.doi.org/10.3350/cmh.2020.0068 |
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author | Jain, Priyanka Shasthry, Saggere Muralikrishna Choudhury, Ashok Kumar Maiwall, Rakhi Kumar, Guresh Bharadwaj, Ankit Arora, Vinod Vijayaraghavan, Rajan Jindal, Ankur Sharma, Manoj Kumar Bhatia, Vikram Sarin, Shiv Kumar |
author_facet | Jain, Priyanka Shasthry, Saggere Muralikrishna Choudhury, Ashok Kumar Maiwall, Rakhi Kumar, Guresh Bharadwaj, Ankit Arora, Vinod Vijayaraghavan, Rajan Jindal, Ankur Sharma, Manoj Kumar Bhatia, Vikram Sarin, Shiv Kumar |
author_sort | Jain, Priyanka |
collection | PubMed |
description | BACKGROUND/AIMS: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. METHODS: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. RESULTS: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. CONCLUSIONS: One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age. |
format | Online Article Text |
id | pubmed-7820216 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Association for the Study of the Liver |
record_format | MEDLINE/PubMed |
spelling | pubmed-78202162021-01-27 Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients Jain, Priyanka Shasthry, Saggere Muralikrishna Choudhury, Ashok Kumar Maiwall, Rakhi Kumar, Guresh Bharadwaj, Ankit Arora, Vinod Vijayaraghavan, Rajan Jindal, Ankur Sharma, Manoj Kumar Bhatia, Vikram Sarin, Shiv Kumar Clin Mol Hepatol Original Article BACKGROUND/AIMS: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. METHODS: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. RESULTS: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. CONCLUSIONS: One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age. The Korean Association for the Study of the Liver 2021-01 2020-12-03 /pmc/articles/PMC7820216/ /pubmed/33317256 http://dx.doi.org/10.3350/cmh.2020.0068 Text en Copyright © 2021 by The Korean Association for the Study of the Liver This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Jain, Priyanka Shasthry, Saggere Muralikrishna Choudhury, Ashok Kumar Maiwall, Rakhi Kumar, Guresh Bharadwaj, Ankit Arora, Vinod Vijayaraghavan, Rajan Jindal, Ankur Sharma, Manoj Kumar Bhatia, Vikram Sarin, Shiv Kumar Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients |
title | Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients |
title_full | Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients |
title_fullStr | Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients |
title_full_unstemmed | Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients |
title_short | Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients |
title_sort | alcohol associated liver cirrhotics have higher mortality after index hospitalization: long-term data of 5,138 patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820216/ https://www.ncbi.nlm.nih.gov/pubmed/33317256 http://dx.doi.org/10.3350/cmh.2020.0068 |
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