[Cause of death in patients with cirrhosis]

Since 1970, the rate of death from cirrhosis has decreased progressively, in part thanks to better handling of complications (preventive and curative treatment of gastric bleeding, prevention of infections and treatment of ascitis). The goal of this study was to examine the evolution in causes of death among cirrhotics.

We identified all of the patients who died among those cirrhotics hospitalized at the Alençon Hospital during the period covered by the study, from January 1, 1993 to December 31, 1998. We examined the age of death of these cirrhotics, their causes of death, and also studied and compared this data with causes of death cited in the literature of the 1980s. Finally, we examined the prevalence of each cause of death in relation to the age of death of each patient.

Our results show that 347 cirrhotics were hospitalized at the Alençon Hospital during the period covered by the study, and 186 of these patients died. These deaths resulted from hepatocarcinoma in 22% of cases, gastric bleeding in 12% of cases, and liver cell failure at a terminal stage in 21% of cases. In 31% of cases, the cause was unrelated to cirrhosis, and in 13% of cases the cause was unknown. The death rate from hepatocarcinoma increased according to the patients' age, while the death rate from gastric bleeding decreased according to age.

We have noted, in comparison with Saunders in 1981 that there was a significant increase in extrahepatic causes of death and a significant decrease in deaths from liver cell failure. Percentages of the other causes of death do not show any variation, in spite of new techniques of detection and treatment.