Jepsen Peter, Vilstrup Hendrik, Mellemkjaer Lene, Thulstrup Ane Marie, Olsen Jørgen H, Baron John A, Sørensen Henrik Toft
Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg Hospital, Denmark.
Hepatogastroenterology. 2003 Nov-Dec;50(54):2101-4.
BACKGROUND/AIMS: There are very limited data available regarding the prognosis of patients with fatty liver. We examined the overall and cause-specific mortality of fatty liver patients in a large Danish cohort.
In the Danish National Registry of Patients, we identified 7,372 patients discharged with a diagnosis of fatty liver from a Danish hospital between 1977 and 1993. Causes of death were identified in the Danish Death Registry. We estimated the standardized mortality ratio by comparing with the general population.
Most patients (76%) had alcoholic fatty liver. During follow-up, 2,914 (40%) died. The commonest cause of death was hepatobiliary disease (25% of deaths). Mortality was increased 5.4-fold (95% CI 5.2-5.6) in patients with alcoholic fatty liver, and 2.6-fold (95% CI 2.4-2.9) in patients with non-alcoholic or unspecified fatty liver. Overall, in the first year of follow-up, mortality was increased more than 7-fold, almost 5-fold in the second to fifth years, and more than 3-fold after that. Mortality was similar among genders and among diabetics and non-diabetics, and remained increased after censoring patients upon diagnosis of liver cirrhosis.
The mortality of patients with a hospital discharge diagnosis of fatty liver was higher than that of the general population.
背景/目的:关于脂肪肝患者预后的数据非常有限。我们在一个大型丹麦队列中研究了脂肪肝患者的全因死亡率和病因特异性死亡率。
在丹麦国家患者登记处,我们确定了1977年至1993年间从丹麦一家医院出院诊断为脂肪肝的7372例患者。在丹麦死亡登记处确定死亡原因。通过与普通人群比较,我们估计了标准化死亡率。
大多数患者(76%)患有酒精性脂肪肝。在随访期间,2914例(40%)死亡。最常见的死亡原因是肝胆疾病(占死亡人数的25%)。酒精性脂肪肝患者的死亡率增加了5.4倍(95%可信区间5.2 - 5.6),非酒精性或未明确类型脂肪肝患者的死亡率增加了2.6倍(95%可信区间2.4 - 2.9)。总体而言,在随访的第一年,死亡率增加了7倍多,在第二至五年增加了近5倍,之后增加了3倍多。性别之间以及糖尿病患者和非糖尿病患者之间的死亡率相似,在诊断为肝硬化后对患者进行审查后死亡率仍然增加。
出院诊断为脂肪肝的患者死亡率高于普通人群。