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Comparative Study
, 10 (1), 95-100

Complications Requiring Hospital Admission and Causes of In-Hospital Death Over Time in Alcoholic and Nonalcoholic Cirrhosis Patients

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Comparative Study

Complications Requiring Hospital Admission and Causes of In-Hospital Death Over Time in Alcoholic and Nonalcoholic Cirrhosis Patients

Hee Yeon Kim et al. Gut Liver.

Abstract

Background/aims: Data on the epidemiology of alcoholic cirrhosis, especially in Asian countries, are limited. We compared the temporal evolution of patterns of alcoholic and nonalcoholic cirrhosis over the last decade.

Methods: We retrospectively examined the inpatient datasets of five referral centers during 2002 and 2011. The study included patients who were admitted due to specific complications of liver cirrhosis. We compared the causes of hospital admissions and in-hospital deaths between patients with alcoholic and nonalcoholic cirrhosis.

Results: Among the included 2,799 hospitalizations (2,165 patients), 1,496 (1,143 patients) were from 2002, and 1,303 (1,022 patients) were from 2011. Over time, there was a reduction in the rate of hepatic encephalopathy (HE) as a cause of hospitalization and an increase in the rate of hepatocellular carcinoma. Deaths that were attributable to HE or spontaneous bacterial peritonitis (SBP) significantly decreased, whereas those due to hepatorenal syndrome (HRS) significantly increased over time in patients with alcoholic cirrhosis. However, in patients with nonalcoholic cirrhosis, hepatic failure and HRS remained the principal causes of in-hospital death during both time periods.

Conclusions: The major causes of in-hospital deaths have evolved from acute cirrhotic complications, including HE or SBP to HRS in alcoholic cirrhosis, whereas those have remained unchanged in nonalcoholic cirrhosis during the last decade.

Keywords: Cause of death; Complications; Hospitalization; Liver cirrhosis.

Figures

Fig. 1
Fig. 1
Comparison of the etiology of liver cirrhosis between (A) 2002 and (B) 2011. In hospitalized patients, alcoholism was the most common cause of liver cirrhosis, followed by hepatitis B infection. HCV, hepatitis C virus; HBV, hepatitis B virus.
Fig. 2
Fig. 2
Decade-long trends in the causes of hospital admissions among patients with (A) alcoholic cirrhosis versus (B) nonalcoholic cirrhosis. HE, hepatic encephalopathy; HCC, hepatocellular carcinoma; SBP, spontaneous bacterial peritonitis; HRS, hepatorenal syndrome. *p<0.05.
Fig. 3
Fig. 3
Decade-long trends in the causes of in-hospital death. (A) Alcoholic cirrhosis and (B) nonalcoholic cirrhosis. HE, hepatic encephalopathy; SBP, spontaneous bacterial peritonitis; HRS, hepatorenal syndrome. *p<0.05.

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