Chronic liver disease in the extremely elderly of 80 years or more: clinical characteristics, prognosis and patient survival analysis.
OBJECTIVE
This study aimed to elucidate the clinical characteristics of patients with chronic liver disease aged 80 years or more, especially the factors affecting prognosis and carcinogenesis.


METHODS
A total of 135 patients aged 80 years or above were divided into chronic liver disease without cirrhosis (non-LC) and cirrhosis (LC) groups according to the severity of fibrosis, and the clinical characteristics and prognoses were evaluated.


RESULTS
Seventy-three (54.1%) of 135 patients were in the LC group and 79 patients (58.5%) had hepatitis C virus. Various concomitant diseases were seen in 122 patients (90.4%). Liver-related deaths occurred in only 19 (36.5%) of 52 patients who died during observation, although 28 patients (53.8%) had liver cancer at the time of death. Cumulative survival rates in the non-LC and the LC groups were 85.7% and 58.8% at the 5th year, and 69.4% and 19.4% at the 9th year, respectively. Cumulative liver cancer appearance rates in the non-LC and the LC groups were 1.6% and 6.1% at the 1st year, 12.4% and 19.9% at the 5th year, and 12.4% and 32.0% at the 7th year, respectively. A multivariate Cox regression analysis revealed that the presence of liver cancer (p=0.0001), platelet count (p=0.0242), and fibrotic stage (p=0.0118) were independently associated with survival period, and alfa-fetoprotein (p=0.0194) and bilirubin (p=0.0282) were independently associated with carcinogenesis.


CONCLUSIONS
Cirrhosis is the major risk factor affecting the prognosis. On the other hand, we must pay more attention to concomitant diseases specific to advanced age.
Hoshida
Y
Y
Division of Gastroenterology, Toranomon Hospital, Tokyo, Japan. yujin-hoshi@eva.hi-ho.ne.jp
Ikeda
K
K
Kobayashi
M
M
Suzuki
Y
Y
Tsubota
A
A
Saitoh
S
S
Arase
Y
Y
Kobayashi
M
M
Murashima
N
N
Chayama
K
K
Kumada
H
H
D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D002423:Cause of Death; D002908:Chronic Disease; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014041:Tokyo; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D001663:Bilirubin