КОМОРБИДНОСТЬ БОЛЬНЫХ ЦИРРОЗОМ ПЕЧЕНИ: ВЛИЯНИЕ НА ТЕЧЕНИЕ И ИСХОДЫ

Abstract

The role of comorbidity in the treatment of liver cirrhosis (LC) and its complications is unknown. Purpose: studying of comorbidity in patients with LC and its impact on outcome of the disease. Materials and methods. 155 patients (women - 49,4%, men - 50,6%, mean age 52,15±12,41) were follow up for 3 year. Viral LC was diagnosed in 33.8%, alcohol LC - 22,1%, autoimmune LC-15, 6%, other causes and cryptogenic causes noted in - 28,5%. More than half of the patients had a class В of Child-Pugh (51.9%). Comorbidity was determined by Charlson and CirCom (Jepsen, 2014) scales. Results: during 3 year of observation 44 people died (28,4%): 33 (75%) patients died from LC complications; 11 (25%) patients died from causes not directly related to LC (4-cancer, 2-diabetes mellitus (DM), 1-trauma, 1-atrial fibrillation, pulmonary embolism-1, stroke-1). 44 patients (28,4%) had no comorbidities. Hypertension was noted at 26.6%, cholelithiasis - 22.1% and DM-14.9%. 41.9% of patients had 1 concomitant disease, 18.7% - 2 diseases, 10.9% - more than three. The number of comorbidities significantly increased the risk of death from causes unrelated to LC (RR: 5,000; 95% CI: 1,426-17, 532). Bilateral positive correlation (rs=0,304, p=0,00012) between the age of patients and the number of comorbidities was revealed. The analysis of the relationship between Charlson and CirCom scales confirmed their correlation at rs=0,543, p=0,0000001. Statistically significant differences of Charlson and CirCom comorbidity were found in groups of patients who died from causes unrelated to LC and lived to the end of the follow-up period (p*=0.000048, p**=0.000243).