Premium
Incidence, clinical presentation and mortality of liver cirrhosis in Southern Sweden: a 10‐year population‐based study
Author(s) -
Nilsson E.,
Anderson H.,
Sargenti K.,
Lindgren S.,
Prytz H.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13635
Subject(s) - medicine , cirrhosis , incidence (geometry) , population , etiology , gastroenterology , mortality rate , alcoholic liver disease , hepatitis c , cumulative incidence , ascites , cohort , physics , environmental health , optics
Summary Background In Sweden, the most common causes of liver cirrhosis are alcohol overconsumption and hepatitis C. However, recent data on the clinical characteristics of Swedish patients with cirrhosis are scarce. Aims To determine the incidence, clinical presentation, aetiological spectrum and survival rates of liver cirrhosis in Southern Sweden from 2001 to 2011. Methods We used population‐based medical registries to conduct a cohort study of all patients with liver cirrhosis in the southernmost region of Sweden with a population of 1.17 million. Medical records and histopathology data were reviewed. Patients were classified according to aetiology, and clinical parameters were registered. Patients were followed until death or December 2014. Results A total of 1317 patients with cirrhosis were identified. The crude annual incidence of cirrhosis was estimated at 14.1/100 000. The most common aetiology was alcohol overconsumption with or without additional causes of cirrhosis (58%) followed by HCV alone (13%) and cryptogenic cirrhosis (12%). At diagnosis, ascites occurred in 43%, variceal bleeding in 6% and overt encephalopathy in 4%. The median follow‐up was 4.3 years. The total 1‐, 5‐ and 10‐year survival rates were 79%, 47% and 27% respectively. Survival rates were better for women than for men. A 10‐year cumulative incidence of transplantation was 7.3%. Mortality was worst for alcoholic cirrhosis with concomitant HCV when adjusted for age and gender. Conclusions Sweden continues to have a low incidence of cirrhosis compared with other European countries. Mortality varies with gender, aetiology and severity at diagnosis. Patients with alcoholic cirrhosis with concomitant HCV infection fare worst.