John Jorge Alberto, de Mattos Angelo Alves, da Silva Miozzo Suelen Aparecida, Comerlato Pedro Henrique, Porto Mariana, Contiero Priscila, da Silva Renata Rodrigues
Departament of Gastroenterology and Hepatology, Faculty of Medicine, Porto Alegre University Federal of Health Sciences (UFCSPA), Porto Alegre, Brazil.
Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1372-7. doi: 10.1097/MEG.0000000000000480.
Cirrhosis represents a public health issue that generally evolves and presents serious complications.
To assess the outcomes of outpatients with cirrhosis.
We used a retrospective outpatient-based cohort, assessing 527 patients with cirrhosis. Demographic, clinical, and laboratory variables were analyzed, as well as the risk factors related to death, using the Cox proportional-hazard regression model. The Kaplan-Meier method was used to analyze survival rates.
Patients had a mean age of 52.9±9.7 years and were more frequently men (59%), presenting Child-Turcotte-Pugh B or C in 43% of the cases in addition to a mean Model for End-Stage Liver Disease score of 12.0±4.1. The predominant etiology of liver disease was the hepatitis C virus. The most frequent complications during follow-up were ascites (34%), hepatic encephalopathy (17%), and hepatocellular carcinoma (17%). The survival rate at years 5 and 10 was 73 and 57%, respectively. The main risk factors that were related to death were, in a multivariate analysis, hepatitis C virus etiology, presence of hepatocellular carcinoma, and serum levels of albumin.
Patients with cirrhosis monitored on an outpatient basis, despite showing a reasonable survival rate, have a worse prognosis when the etiology of liver disease is related to hepatitis C virus and when they have hepatocellular carcinoma or hypoalbuminemia.
肝硬化是一个公共卫生问题，通常会不断发展并出现严重并发症。
评估肝硬化门诊患者的预后情况。
我们采用了一项基于门诊患者的回顾性队列研究，评估了527例肝硬化患者。分析了人口统计学、临床和实验室变量，以及使用Cox比例风险回归模型分析与死亡相关的危险因素。采用Kaplan-Meier方法分析生存率。
患者的平均年龄为52.9±9.7岁，男性更为常见（59%），43%的病例为Child-Turcotte-Pugh B级或C级，终末期肝病模型平均评分为12.0±4.1。肝病的主要病因是丙型肝炎病毒。随访期间最常见的并发症是腹水（34%）、肝性脑病（17%）和肝细胞癌（17%）。5年和10年的生存率分别为73%和57%。在多变量分析中，与死亡相关的主要危险因素是丙型肝炎病毒病因、肝细胞癌的存在以及血清白蛋白水平。
门诊监测的肝硬化患者，尽管生存率较为合理，但当肝病病因与丙型肝炎病毒有关，以及患有肝细胞癌或低白蛋白血症时，预后较差。
