A prospective cohort study on the clinical characteristics and risk factors of long-term prognosis in patients with decompensated cirrhosis due to different etiologies

Abstract

Abstract: Objective To study on the clinical characteristics and risk factors of long-term prognosis of patients with decompensated cirrhosis due to different etiologies.Methods Six hundred and forty-three patients with decompensated cirrhosis were prospectively enrolled in this study. Clinical data and laboratory indicators were collected in all patients for identifying the etiologies of liver diseases. The relationship between different etiologies with long-term prognosis were compared and the impact factors for long-term prognosis were analyzed by COX survival. Results Of the 643 patients with decompensated cirrhosis, 235 died in 2 years and the mortality was 36.5%. The 2-year mortality rate of HBV related cirrhosis, hepatitis B combined with alcoholic cirrhosis, alcoholic cirrhosis, other etiologies, and cryptogenic cirrhosis was 28.7% 45.0% 40.2% 42.7% and 53.2%, respectively (P value <0.05). Compared with HBV-related cirrhosis, patients with alcoholic cirrhosis were older, male predominant, and higher in 2-year mortality. The cirrhotic patients with unknown etiologies were the oldest, female in majority, with higher incidence of bacterial infection, and the worst long-term prognosis. Univariate COX regression analysis shown that age, mean arterial pressure (MAP), diabetes, previous decompensation, etiology, ascites, upper gastrointestinal bleeding, bacterial infection, hepatic encephalopathy, aspartate aminotransferase (AST), albumin (ALB), total Bilirubin (TBIL), International normalized ratio (INR), serum sodium, white blood cell count (WBC), creatinine (Cr), platelet count (PLT) and the prognostic models were associated with the 2-year mortality. By multivariate COX regression analysis it was found that age, etiology, serum sodium, platelet, albumin and Model for end-stage liver disease (MELD) score were independent risk factors of 2-year mortality in decompensated cirrhosis.Conclusion Patients with HBV related decompensated cirrhosis have the best whereas those with cryptogenic cirrhosis have the worst long-term prognosis. Age, etiology, serum sodium level, platelet count, albumin level, and MELD score are independent risk factors for the long-term prognosis in patients with decompensated cirrhosis.

Key words: Decompensated cirrhosis, Etiology, Clinical characteristics, Long-term prognosis, Risk factors

DU Jing-yuan, YAN Hua-dong. A prospective cohort study on the clinical characteristics and risk factors of long-term prognosis in patients with decompensated cirrhosis due to different etiologies[J]. Chinese Hepatolgy, 2021, 26(2): 140-146.

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