title: All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study.
abstract: BACKGROUND
  Mortality due to cirrhosis has tripled over the last 30 years in the UK. However, we lack adequate, contemporary, population-based estimates of the excess mortality patients who are at risk compared with the general population.
  
  
  OBJECTIVE
  To determine the overall survival in patients with cirrhosis compared with the general population taking into account the effects of severity and aetiology of disease and comorbidity.
  
  
  METHODS
  In a cohort study, we identified 4537 people with cirrhosis and a control cohort of 44 403 patients, matched by age, sex and general practice from the UK General Practice Research Database between June 1987 and April 2002.
  
  
  RESULTS
  Patients with compensated cirrhosis had a nearly five-fold [hazard ratio (HR) 4.7, 95% confidence interval (CI) 4.4-5.0] increased risk of death, while those with decompensated cirrhosis had a near 10-fold (HR 9.7, 95% CI 8.9-10.6) increased risk compared with the general population. Alcoholic cirrhosis conferred a worse prognosis than non-alcohol-related cirrhosis both in the first year following diagnosis and subsequently.
  
  
  CONCLUSIONS
  Having a diagnosis of cirrhosis confers a substantial increased mortality risk compared with the general population, even for those with compensated disease, with 5-year survival between that seen for breast and colorectal cancer.
authors: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. kate.fleming@nottingham.ac.uk
authors: Kate M
authors: KM
authors: Fleming
authors: Guruprasad P
authors: GP
authors: Aithal
authors: Tim R
authors: TR
authors: Card
authors: Joe
authors: J
authors: West
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology