Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study
Abstract
:1. Introduction
2. Methods
2.1. Study Population and Design
2.2. Comorbidities and Complications
2.3. Study Endpoint Measurement
2.4. Statistical and Data Analysis
2.5. Ethics
3. Results
3.1. Concomitant Comorbidities and Complications of Liver Cirrhosis
3.2. Hazard Ratios for Comorbidities, Complications of Liver Cirrhosis, and Survival
3.3. Survival Analysis Between the Two Study Groups
4. Discussion
4.1. Main Findings
4.2. Comparison with Other Studies
4.3. Clinical Implications
4.4. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Alcoholic Cirrhosis | Non-Alcoholic Cirrhosis | p-Value | ||
---|---|---|---|---|---|
N = 472 | N = 4313 | ||||
N | % | N | % | ||
Sex | <0.001 | ||||
Male | 447 | 94.7 | 2699 | 62.6 | |
Female | 25 | 5.3 | 1614 | 37.4 | |
Age (years) | <0.001 | ||||
40–49 | 220 | 46.6 | 601 | 13.9 | |
50–59 | 152 | 32.2 | 1015 | 23.5 | |
60–69 | 68 | 14.4 | 974 | 22.6 | |
>69 | 32 | 6.8 | 1723 | 39.9 | |
Residence | <0.001 | ||||
Metropolis | 246 | 52.1 | 2403 | 55.7 | |
General area | 205 | 43.4 | 1837 | 42.6 | |
Remote area | 20 | 4.2 | 68 | 1.6 | |
Income (New Taiwan Dollar (NTD) per month) | <0.001 | ||||
0–14,009 | 201 | 42.6 | 2175 | 50.4 | |
14,010-42,030 | 248 | 52.5 | 1838 | 42.6 | |
>42,939 | 22 | 4.7 | 295 | 6.8 | |
Etiologies of non-alcoholic cirrhosis | |||||
Hepatitis B | 1417 | 32.9 | |||
Hepatitis C | 1377 | 31.9 | |||
Non-alcoholic fatty liver disease | 428 | 9.9 | |||
Others (biliary cirrhosis excluded) | 1091 | 25.3 | |||
Comorbidity | <0.001 | ||||
Yes | 324 | 68.6 | 3431 | 79.6 | |
No | 148 | 31.4 | 882 | 20.4 | |
Coronary heart disease (CAD) | 63 | 13.3 | 1091 | 25.3 | <0.001 |
Cerebrovascular disease | |||||
Hemorrhage | 15 | 3.2 | 578 | 13.4 | <0.001 |
Ischemia | 24 | 5.1 | 684 | 15.9 | <0.001 |
Hypertension | 197 | 41.7 | 2526 | 58.6 | <0.001 |
Heart failure (HF) | 25 | 5.3 | 551 | 12.8 | <0.001 |
Diabetes mellitus (DM) | 137 | 29.0 | 1584 | 36.7 | <0.001 |
Chronic kidney disease (CKD) | 72 | 15.3 | 970 | 22.5 | <0.001 |
Hyperlipidemia | 118 | 25.0 | 1035 | 24.0 | 0.629 |
Chronic obstructive pulmonary disease (COPD) | 59 | 12.5 | 903 | 20.9 | <0.001 |
Complication of cirrhosis | 0.007 | ||||
Yes | 152 | 32.2 | 1663 | 38.6 | |
No | 320 | 67.8 | 2650 | 61.4 | |
Ascites or peritonitis | 79 | 16.7 | 1012 | 23.5 | <0.001 |
Hepatic encephalopathy | 54 | 11.4 | 553 | 12.8 | 0.392 |
Esophageal varices | 57 | 12.1 | 656 | 15.2 | 0.069 |
Esophageal varices without bleeding | 25 | 5.3 | 396 | 9.2 | 0.005 |
Esophageal varices with bleeding | 45 | 9.5 | 456 | 10.6 | 0.484 |
Variable | Alcoholic Cirrhosis | Non-Alcoholic Cirrhosis | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Unadjusted Hazard Ratio | a Adjusted Hazard Ratio | Unadjusted Hazard Ratio | a Adjusted Hazard Ratio | |||||||||
Risk Ratio | 95% CI | p-Value | Risk Ratio | 95% CI | p-Value | Risk Ratio | 95% CI | p-Value | Risk Ratio | 95% CI | p-Value | |
Sex | ||||||||||||
Male | 0.703 | 0.371–1.335 | 0.282 | 0.777 | 0.399–1.512 | 0.458 | 1.114 | 1.008–1.232 | 0.034 | 1.241 | 1.119-1.376 | <0.001 |
Female (reference) | ||||||||||||
Age (years) | ||||||||||||
40–49 (reference) | ||||||||||||
50–59 | 1.255 | 0.877–1.795 | 0.214 | 1.335 | 0.923–1.930 | 0.124 | 1.070 | 0.883–1.297 | 0.489 | 1.114 | 0.918–1.351 | 0.275 |
60–69 | 0.793 | 0.465–1.353 | 0.395 | 0.848 | 0.489–1.472 | 0.559 | 1.258 | 1.041–1.521 | 0.017 | 1.344 | 1.105–1.635 | 0.003 |
>69 | 2.541 | 1.540–4.193 | <0.001 | 2.004 | 1.115–3.603 | 0.020 | 2.487 | 2.104–2.939 | <0.001 | 2.675 | 2.229–3.212 | <0.001 |
Comorbidity | ||||||||||||
Coronary heart disease | 1.098 | 0.700–1.723 | 0.685 | 1.170 | 0.703-1.948 | 0.546 | 1.129 | 1.014-1.257 | 0.027 | 0.886 | 0.785-1.000 | 0.050 |
Cerebrovascular disease | ||||||||||||
Hemorrhage | 1.799 | 0.883–3.666 | 0.106 | 1.578 | 0.732–3.400 | 0.244 | 1.356 | 1.077–1.706 | 0.01 | 1.377 | 1.090–1.738 | 0.007 |
Ischemia | 1.279 | 0.692–2.361 | 0.432 | 0.879 | 0.439–1.758 | 0.715 | 1.221 | 1.071–1.393 | 0.003 | 0.950 | 0.827–1.092 | 0.470 |
Hypertension | 0.845 | 0.614–1.162 | 0.300 | 0.684 | 0.471–0.994 | 0.046 | 1.059 | 0.960–1.167 | 0.253 | 0.783 | 0.698–0.878 | <0.001 |
Heart failure | 1.393 | 0.754–2.571 | 0.290 | 0.981 | 0.477–2.016 | 0.958 | 1.510 | 1.328–1.715 | <0.001 | 1.136 | 0.987–1.308 | 0.076 |
Diabetes mellitus | 0.958 | 0.683–1.343 | 0.802 | 1.056 | 0.732–1.524 | 0.771 | 1.047 | 0.949–1.156 | 0.360 | 1.090 | 0.981–1.212 | 0.110 |
Chronic kidney disease | 2.137 | 1.488–3.070 | <0.001 | 2.276 | 1.520–3.409 | <0.001 | 1.881 | 1.698–2.084 | <0.001 | 1.751 | 1.571–1.951 | <0.001 |
Hyperlipidemia | 0.452 | 0.293–0.699 | <0.001 | 0.447 | 0.282–0.708 | <0.001 | 0.574 | 0.505–0.653 | <0.001 | 0.571 | 0.499–0.652 | <0.001 |
Chronic obstructive pulmonary disease | 1.227 | 0.800-1.883 | 0.348 | 1.240 | 0.789-1.951 | 0.351 | 1.346 | 1.205-1.502 | <0.001 | 0.994 | 0.883-1.119 | 0.920 |
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Yang, T.-W.; Wang, C.-C.; Tsai, M.-C.; Wang, Y.-T.; Tseng, M.-H.; Lin, C.-C. Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study. Int. J. Environ. Res. Public Health 2020, 17, 2825. https://doi.org/10.3390/ijerph17082825
Yang T-W, Wang C-C, Tsai M-C, Wang Y-T, Tseng M-H, Lin C-C. Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study. International Journal of Environmental Research and Public Health. 2020; 17(8):2825. https://doi.org/10.3390/ijerph17082825
Chicago/Turabian StyleYang, Tzu-Wei, Chi-Chih Wang, Ming-Chang Tsai, Yao-Tung Wang, Ming-Hseng Tseng, and Chun-Che Lin. 2020. "Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study" International Journal of Environmental Research and Public Health 17, no. 8: 2825. https://doi.org/10.3390/ijerph17082825