Open AccessHigh frequency of acute decompensation and cancer in patients with compensated cirrhosis due to nonalcoholic fatty liver disease: A retrospective cohort study
Author(s) -
Bassegoda Octavi,
RiveraEsteban Jesús,
Serra Isabel,
Morillas Rosa,
Broquetas Teresa,
Vergara Mercedes,
Rodriguez Adrià,
Aracil Carles,
Virolés Silvia,
Carrión Jose A.,
Pardo Albert,
RodríguezTajes Sergio,
SerraBurriel Miquel,
Pericàs Juan M.,
Augustin Salvador,
Ginès Pere,
Graupera Isabel
Publication year - 2022
Publication title -
hepatology communications
Language(s) - English
Resource type - Journals
ISSN - 2471-254X
DOI - 10.1002/hep4.2056
Subject(s) - decompensation , medicine , cirrhosis , hepatocellular carcinoma , nonalcoholic fatty liver disease , ascites , gastroenterology , spontaneous bacterial peritonitis , chronic liver disease , cancer , retrospective cohort study , fatty liver , disease
The natural history of compensated cirrhosis due to nonalcoholic fatty liver disease (NAFLD) has not been completely characterized. The aim of the present study was to assess the incidence and risk factors of acute decompensation of cirrhosis, hepatocellular carcinoma, and extrahepatic cancers. This was a multicenter, retrospective, cohort study including 449 patients with compensated cirrhosis due to NAFLD. We calculated cumulative incidences and used competitive risk analysis to determine the risk factors associated with decompensation and cancer development. Over a median of 39 months of follow‐up, 124 patients (28%) presented acute decompensation. The most frequent decompensation was ascites (21%) followed by hepatic encephalopathy (15%), variceal bleeding (9%), and spontaneous bacterial peritonitis (3%). Acute‐on‐chronic liver failure was diagnosed in 6% of patients during follow‐up. Liver function parameters and specifically an albumin level below 40 g/L were independently associated with an increased risk of decompensation. The presence of ischemic heart disease was independently associated with acute decompensation. Seventy‐eight patients (18%) developed hepatocellular carcinoma or extrahepatic cancers during follow‐up (51 and 27, respectively). Conclusion : Patients with compensated cirrhosis due to NAFLD are at high risk of severe liver complications, such as the development of acute decompensation, in a relative short follow‐up time. This population is at high risk of hepatic and extrahepatic cancers.