Abstract
The prognosis of different etiologies of liver cirrhosis (LC) is not well understood. Previous studies performed on alcoholic LC-dominated cohorts have demonstrated a few conflicting results. We aimed to compare the outcome and the effect of comorbidities on survival between alcoholic and non-alcoholic LC in a viral hepatitis-dominated LC cohort. We identified newly diagnosed alcoholic and non-alcoholic LC patients, aged ≥40 years old, between 2006 and 2011, by using the Longitudinal Health Insurance Database. The hazard ratios (HRs) were calculated using the Cox proportional hazards model and the Kaplan–Meier method. A total of 472 alcoholic LC and 4313 non-alcoholic LC patients were identified in our study cohort. We found that alcoholic LC patients were predominantly male (94.7% of alcoholic LC and 62.6% of non-alcoholic LC patients were male) and younger (78.8% of alcoholic LC and 37.4% of non-alcoholic LC patients were less than 60 years old) compared with non-alcoholic LC patients. Non-alcoholic LC patients had a higher rate of concomitant comorbidities than alcoholic LC patients (79.6% vs. 68.6%, p < 0.001). LC patients with chronic kidney disease demonstrated the highest adjusted HRs of 2.762 in alcoholic LC and 1.751 in non-alcoholic LC (all p < 0.001). In contrast, LC patients with hypertension and hyperlipidemia had a decreased risk of mortality. The six-year survival rates showed no difference between both study groups (p = 0.312). In conclusion, alcoholic LC patients were younger and had lower rates of concomitant comorbidities compared with non-alcoholic LC patients. However, all-cause mortality was not different between alcoholic and non-alcoholic LC patients.
Highlights
Liver cirrhosis (LC) resulting from different etiologies is a leading cause of death, which accounts for 3.5% of all death worldwide [1,2]
80% of alcoholic LC patients were diagnosed at the age of 40–59 years
The residential urbanization level was different among both groups, with a smaller number of patients from remote area compared to metropolis and general area in both the groups
Summary
Tzu-Wei Yang 1,2,3 , Chi-Chih Wang 1,2,3 , Ming-Chang Tsai 1,2,3 , Yao-Tung Wang 1,2,4 , Ming-Hseng Tseng 5,6, *,† and Chun-Che Lin 7,8, *,†. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical. Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical. Information Technology Office, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
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