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All‐cause mortality in people with cirrhosis compared with the general population: a population‐based cohort study
Author(s) -
Fleming Kate M.,
Aithal Guruprasad P.,
Card Tim R.,
West Joe
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02517.x
Subject(s) - medicine , cirrhosis , population , hazard ratio , cohort , alcoholic liver disease , cohort study , comorbidity , mortality rate , confidence interval , environmental health
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.