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All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study

Kate M Fleming1, Guruprasad P Aithal, Tim R Card

  • 1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. kate.fleming@nottingham.ac.uk

Liver International : Official Journal of the International Association for the Study of the Liver
|July 13, 2011
PubMed

Insights

Patients with cirrhosis face significantly higher mortality risk compared to the general population. Even compensated cirrhosis shows a five-fold increased risk, highlighting the severe impact of this liver disease.

Area of Science:

  • Hepatology
  • Public Health
  • Epidemiology

Background:

  • Cirrhosis mortality has tripled in the UK over 30 years.
  • Population-based estimates of excess mortality in cirrhosis patients are lacking.
  • Understanding contemporary survival rates is crucial for public health initiatives.

Purpose of the Study:

  • To quantify overall survival in cirrhosis patients versus the general population.
  • To analyze the impact of disease severity and etiology on survival.
  • To account for comorbidities in survival estimations.

Main Methods:

  • A UK cohort study identified 4537 cirrhosis patients.
  • A control cohort of 44,403 patients was matched by age, sex, and general practice.
  • Data sourced from the UK General Practice Research Database (1987-2002).

Main Results:

  • Compensated cirrhosis patients had a ~5-fold increased mortality risk (HR 4.7).
  • Decompensated cirrhosis patients faced a ~10-fold increased risk (HR 9.7).
  • Alcoholic cirrhosis showed a worse prognosis than non-alcoholic cirrhosis.

Conclusions:

  • Cirrhosis diagnosis substantially increases mortality risk versus the general population.
  • Even compensated cirrhosis carries significant excess mortality.
  • Five-year survival for cirrhosis patients falls between that of breast and colorectal cancer.
Abstract

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