アブストラクト | BACKGROUND & AIMS: Large, population-based studies that have included the full spectrum of cirrhosis estimating survival, taking into account time-at-risk are lacking. We aimed to report 1- and 5-year average survival rates for people with cirrhosis to be used in a clinical and healthcare policy setting. METHODS: We used the Clinical Practice Research Datalink and linked English Hospital Episode Statistics to identify adult cases of cirrhosis from January 1998 to December 2009. We estimated 1- and 5-year survival according to whether time-at-risk was ambulatory or followed an emergency hospital admission related to liver disease, stratified by age, sex, and aetiology to be used in a clinical setting. We used a multivariate Cox-proportional hazards model with a time-varying variable, adjusted for Baveno IV stage of cirrhosis at diagnosis, age, aetiology, and sex. RESULTS: We identified 5118 incident cases. Average survival probabilities at 1- and 5-years were 0.84 (95% CI 0.83-0.86) and 0.66 (95% CI 0.63-0.68) for the ambulatory group and 0.55 (95% CI 0.53-0.57) and 0.31 (95% CI 0.29-0.33) following hospitalisation, respectively. A hospital admission at diagnosis or subsequently for liver disease substantially impaired prognosis independent of stage of cirrhosis (HR=2.78, 95% CI 2.53, 3.06). CONCLUSIONS: Emergency hospitalisation for liver disease heralds a downturn in a patient's outlook independent of their stage of cirrhosis. Our results provide population-based clinically translatable estimates of prognosis for the purposes of healthcare delivery and planning and communication to patients. |
ジャーナル名 | Journal of hepatology |
投稿日 | 2013/10/17 |
投稿者 | Ratib, Sonia; Fleming, Kate M; Crooks, Colin J; Aithal, Guruprasad P; West, Joe |
組織名 | Division of Epidemiology & Public Health, University of Nottingham, UK.;Electronic address: sonia.ratib@nottingham.ac.uk.;NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, Nottingham;University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/24128415/ |