1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study

BACKGROUND & AIMS: Large, population-based studies that have included the full spectrum of cirrhosis estimating survival, taking into account time-at-risk are lacking. We aimed to report 1- and 5-year average survival rates for people with cirrhosis to be used in a clinical and healthcare polic...

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Main Authors: Ratib, Sonia, Fleming, Kate M., Crooks, Colin J., Aithal, Guru P., West, Joe
Format: Article
Published: Elsevier 2014
Subjects:
Online Access:https://eprints.nottingham.ac.uk/32563/
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author Ratib, Sonia
Fleming, Kate M.
Crooks, Colin J.
Aithal, Guru P.
West, Joe
author_facet Ratib, Sonia
Fleming, Kate M.
Crooks, Colin J.
Aithal, Guru P.
West, Joe
author_sort Ratib, Sonia
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND & AIMS: Large, population-based studies that have included the full spectrum of cirrhosis estimating survival, taking into account time-at-risk are lacking. We aimed to report 1- and 5-year average survival rates for people with cirrhosis to be used in a clinical and healthcare policy setting. METHODS: We used the Clinical Practice Research Datalink and linked English Hospital Episode Statistics to identify adult cases of cirrhosis from January 1998 to December 2009. We estimated 1- and 5-year survival according to whether time-at-risk was ambulatory or followed an emergency hospital admission related to liver disease, stratified by age, sex, and aetiology to be used in a clinical setting. We used a multivariate Cox-proportional hazards model with a time-varying variable, adjusted for Baveno IV stage of cirrhosis at diagnosis, age, aetiology, and sex. RESULTS: We identified 5118 incident cases. Average survival probabilities at 1- and 5-years were 0.84 (95% CI 0.83-0.86) and 0.66 (95% CI 0.63-0.68) for the ambulatory group and 0.55 (95% CI 0.53-0.57) and 0.31 (95% CI 0.29-0.33) following hospitalisation, respectively. A hospital admission at diagnosis or subsequently for liver disease substantially impaired prognosis independent of stage of cirrhosis (HR=2.78, 95% CI 2.53, 3.06). CONCLUSIONS: Emergency hospitalisation for liver disease heralds a downturn in a patient's outlook independent of their stage of cirrhosis. Our results provide population-based clinically translatable estimates of prognosis for the purposes of healthcare delivery and planning and communication to patients.
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spelling nottingham-325632020-05-04T16:40:55Z https://eprints.nottingham.ac.uk/32563/ 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study Ratib, Sonia Fleming, Kate M. Crooks, Colin J. Aithal, Guru P. West, Joe BACKGROUND & AIMS: Large, population-based studies that have included the full spectrum of cirrhosis estimating survival, taking into account time-at-risk are lacking. We aimed to report 1- and 5-year average survival rates for people with cirrhosis to be used in a clinical and healthcare policy setting. METHODS: We used the Clinical Practice Research Datalink and linked English Hospital Episode Statistics to identify adult cases of cirrhosis from January 1998 to December 2009. We estimated 1- and 5-year survival according to whether time-at-risk was ambulatory or followed an emergency hospital admission related to liver disease, stratified by age, sex, and aetiology to be used in a clinical setting. We used a multivariate Cox-proportional hazards model with a time-varying variable, adjusted for Baveno IV stage of cirrhosis at diagnosis, age, aetiology, and sex. RESULTS: We identified 5118 incident cases. Average survival probabilities at 1- and 5-years were 0.84 (95% CI 0.83-0.86) and 0.66 (95% CI 0.63-0.68) for the ambulatory group and 0.55 (95% CI 0.53-0.57) and 0.31 (95% CI 0.29-0.33) following hospitalisation, respectively. A hospital admission at diagnosis or subsequently for liver disease substantially impaired prognosis independent of stage of cirrhosis (HR=2.78, 95% CI 2.53, 3.06). CONCLUSIONS: Emergency hospitalisation for liver disease heralds a downturn in a patient's outlook independent of their stage of cirrhosis. Our results provide population-based clinically translatable estimates of prognosis for the purposes of healthcare delivery and planning and communication to patients. Elsevier 2014-02-01 Article PeerReviewed Ratib, Sonia, Fleming, Kate M., Crooks, Colin J., Aithal, Guru P. and West, Joe (2014) 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study. Journal of Hepatology, 60 (2). pp. 282-289. ISSN 1600-0641 cirrhosis survival aetiology population-based http://www.sciencedirect.com/science/article/pii/S0168827813006910 doi:10.1016/j.jhep.2013.09.027 doi:10.1016/j.jhep.2013.09.027
spellingShingle cirrhosis
survival
aetiology
population-based
Ratib, Sonia
Fleming, Kate M.
Crooks, Colin J.
Aithal, Guru P.
West, Joe
1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
title 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
title_full 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
title_fullStr 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
title_full_unstemmed 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
title_short 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study
title_sort 1 and 5 year survival estimates for people with cirrhosis of the liver in england, 1998–2009: a large population study
topic cirrhosis
survival
aetiology
population-based
url https://eprints.nottingham.ac.uk/32563/
https://eprints.nottingham.ac.uk/32563/
https://eprints.nottingham.ac.uk/32563/