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

Background: Mortality due to cirrhosis has tripled over the last 30 years in the UK. However, we lack adequate, contemporary, population-based estimates of the excess mortality patients who are at risk compared with the general population. Aim: To determine the overall survival in patients with cir...

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Main Authors: Fleming, Kate M., Aithal, Guruprasad P., Card, Tim R., West, Joe
Format: Article
Published: Wiley 2012
Online Access:https://eprints.nottingham.ac.uk/45119/
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author Fleming, Kate M.
Aithal, Guruprasad P.
Card, Tim R.
West, Joe
author_facet Fleming, Kate M.
Aithal, Guruprasad P.
Card, Tim R.
West, Joe
author_sort Fleming, Kate M.
building Nottingham Research Data Repository
collection Online Access
description Background: Mortality due to cirrhosis has tripled over the last 30 years in the UK. However, we lack adequate, contemporary, population-based estimates of the excess mortality patients who are at risk compared with the general population. Aim: To determine the overall survival in patients with cirrhosis compared with the general population taking into account the effects of severity and aetiology of disease and comorbidity. Methods: In a cohort study, we identified 4537 people with cirrhosis and a control cohort of 44 403 patients, matched by age, sex and general practice from the UK General Practice Research Database between June 1987 and April 2002. Results: Patients with compensated cirrhosis had a nearly five-fold [hazard ratio (HR) 4.7, 95% confidence interval (CI) 4.4–5.0] increased risk of death, while those with decompensated cirrhosis had a near 10-fold (HR 9.7, 95% CI 8.9–10.6) increased risk compared with the general population. Alcoholic cirrhosis conferred a worse prognosis than non-alcohol-related cirrhosis both in the first year following diagnosis and subsequently. Conclusion: Having a diagnosis of cirrhosis confers a substantial increased mortality risk compared with the general population, even for those with compensated disease, with 5-year survival between that seen for breast and colorectal cancer.
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spelling nottingham-451192020-05-04T16:32:18Z https://eprints.nottingham.ac.uk/45119/ All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study Fleming, Kate M. Aithal, Guruprasad P. Card, Tim R. West, Joe Background: Mortality due to cirrhosis has tripled over the last 30 years in the UK. However, we lack adequate, contemporary, population-based estimates of the excess mortality patients who are at risk compared with the general population. Aim: To determine the overall survival in patients with cirrhosis compared with the general population taking into account the effects of severity and aetiology of disease and comorbidity. Methods: In a cohort study, we identified 4537 people with cirrhosis and a control cohort of 44 403 patients, matched by age, sex and general practice from the UK General Practice Research Database between June 1987 and April 2002. Results: Patients with compensated cirrhosis had a nearly five-fold [hazard ratio (HR) 4.7, 95% confidence interval (CI) 4.4–5.0] increased risk of death, while those with decompensated cirrhosis had a near 10-fold (HR 9.7, 95% CI 8.9–10.6) increased risk compared with the general population. Alcoholic cirrhosis conferred a worse prognosis than non-alcohol-related cirrhosis both in the first year following diagnosis and subsequently. Conclusion: Having a diagnosis of cirrhosis confers a substantial increased mortality risk compared with the general population, even for those with compensated disease, with 5-year survival between that seen for breast and colorectal cancer. Wiley 2012-01-03 Article PeerReviewed Fleming, Kate M., Aithal, Guruprasad P., Card, Tim R. and West, Joe (2012) All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver International, 32 (1). pp. 79-84. ISSN 1478-3231 http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02517.x/abstract doi:10.1111/j.1478-3231.2011.02517.x doi:10.1111/j.1478-3231.2011.02517.x
spellingShingle Fleming, Kate M.
Aithal, Guruprasad P.
Card, Tim R.
West, Joe
All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
title All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
title_full All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
title_fullStr All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
title_full_unstemmed All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
title_short All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
title_sort all-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study
url https://eprints.nottingham.ac.uk/45119/
https://eprints.nottingham.ac.uk/45119/
https://eprints.nottingham.ac.uk/45119/