Risk factors for liver-related mortality in chronic hepatitis C patients: a deceased case-living control study.
OBJECTIVE
To investigate the risk factors for liver-related mortality in chronic hepatitis C (CHC) patients.


METHODS
All deceased CHC inpatient data were collected from the Beijing 302 Hospital clinical database, which includes more than 8250 CHC inpatients during the period from 2002 to 2012. The controls were matched to cases by age (± 2 years), sex and date of hospital admission (within the same year). Potential risk factors were included for the evaluation, and odds ratios (OR) and 95%CI were estimated using univariate (unadjusted) and multivariate (adjusted OR, AOR) conditional logistic regression. All statistical tests were two-sided. P values < 0.05 were considered statistically significant.


RESULTS
Based on examinations of 144 CHC-related deceased cases and 576 controls, we found that antiviral therapy with interferon-α was associated with a 47% decrease in the risk of hepatic mortality (AOR = 0.53, 95%CI: 0.28-0.99, P = 0.048). Additionally, the initial diagnostic stage of the disease (AOR = 2.89, 95%CI: 1.83-4.56 and P < 0.001 for liver cirrhosis/AOR = 8.82, 95%CI: 3.99-19.53 and P < 0.001 for HCC compared with CHC), diabetes (AOR = 2.35, 95%CI: 1.40-3.95, P = 0.001), hypertension (AOR = 1.76, 95%CI: 1.09-2.82, P = 0.020), alcohol consumption (AOR = 1.73, 95%CI: 1.03-2.81, P = 0.037) and HBsAg positivity (AOR = 22.28, 95%CI: 5.58-89.07, P < 0.001) were associated with a significant increase in the risk of liver-related mortality in CHC patients.


CONCLUSIONS
This study indicates that interferon-α treatment, the stage at the initial diagnosis of the disease and comorbidities are all independent risk factors for liver-related mortality in CHC patients.
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Qing-Lei
QL
Zeng
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Guo-Hua
GH
Feng
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Ji-Yuan
JY
Zhang
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Yan
Y
Chen
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Bin
B
Yang
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Hui-Huang
HH
Huang
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Xue-Xiu
XX
Zhang
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Zheng
Z
Zhang
Qing-Lei Zeng, Guo-Hua Feng, Xue-Xiu Zhang, Fu-Sheng Wang, The Institute of Translational Hepatology, Beijing 302 Hospital, Peking University Health Science Center, Beijing 100039, China.
Fu-Sheng
FS
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D002423:Cause of Death; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents
Case control study; Chronic hepatitis C; Hepatitis C virus; Mortality; Risk factor