The prognosis of liver cirrhosis in recent years in Korea.
The survival of a recent series of 823 cirrhosis patients who were followed up for a mean of 48 months was analyzed. Cirrhosis was ascribed to alcohol (26%), hepatitis virus B (58%), hepatitis virus C (11%) or both (2%), or was cryptogenic (3%). Features of decompensation were observed in 51% of the patients at entry, and newly developed in 44% of compensated patients within 5 yr. The 5-yr survival after decompensation was 25%. The leading causes of death were liver failure (53%), hepatocellular carcinoma (HCC, 23%), and variceal bleeding (10%). Early detection of HCC significantly improved the survival of cirrhosis patients. Biannual ultrasonography increased the detection rate of small HCC. Mortality of variceal hemorrhage was much lower in patients with Child-Pugh scores from 5 to 8 than in those with scores above 8 (5% vs. 52%). Endoscopic prophylaxis significantly decreased the incidence of first variceal hemorrhage, but the effect was insufficient to improve the rate of survival. Mortality of first spontaneous bacterial peritonitis was 18%. These data suggest that the mortality of major complications of liver cirrhosis has considerably decreased during the last two decades, while there was no remarkable improvement in long-term survival. More efficient management of etiologic factors would be required.
Kim
Young Sun
YS
Institution of Digestive Disease and Nutrition, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
Um
Soon Ho
SH
Ryu
Ho Sang
HS
Lee
Jung Bok
JB
Lee
Jae Won
JW
Park
Dong Kyu
DK
Kim
Yong Sik
YS
Jin
Yoon Tae
YT
Chun
Hoon Jai
HJ
Lee
Hong Sik
HS
Lee
Sang Woo
SW
Choi
Jai Hyun
JH
Kim
Chang Duck
CD
Hyun
Jin Hai
JH
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D007723:Korea; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010538:Peritonitis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate