Survival and risk factors related to death in outpatients with cirrhosis treated in a clinic in Southern Brazil

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Abstract

Introduction

Cirrhosis represents a public health issue that generally evolves and presents serious complications.

Objectives

To assess the outcomes of outpatients with cirrhosis.

Patients and methods

We used a retrospective outpatient-based cohort, assessing 527 patients with cirrhosis. Demographic, clinical, and laboratory variables were analyzed, as well as the risk factors related to death, using the Cox proportional-hazard regression model. The Kaplan–Meier method was used to analyze survival rates.

Results

Patients had a mean age of 52.9±9.7 years and were more frequently men (59%), presenting Child–Turcotte–Pugh B or C in 43% of the cases in addition to a mean Model for End-Stage Liver Disease score of 12.0±4.1. The predominant etiology of liver disease was the hepatitis C virus. The most frequent complications during follow-up were ascites (34%), hepatic encephalopathy (17%), and hepatocellular carcinoma (17%). The survival rate at years 5 and 10 was 73 and 57%, respectively. The main risk factors that were related to death were, in a multivariate analysis, hepatitis C virus etiology, presence of hepatocellular carcinoma, and serum levels of albumin.

Conclusion

Patients with cirrhosis monitored on an outpatient basis, despite showing a reasonable survival rate, have a worse prognosis when the etiology of liver disease is related to hepatitis C virus and when they have hepatocellular carcinoma or hypoalbuminemia.

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