Noble J A, Caces M F, Steffens R A, Stinson F S
Division of Biometry and Epidemiology, NIAAA, Rockville, MD 20857.
Public Health Rep. 1993 Mar-Apr;108(2):192-7.
The decline in cirrhosis mortality in recent years in light of increases in cirrhosis morbidity, as reflected in hospital discharge data, is examined. Although there does not appear to be a single explanation for the decline in mortality, it is suggested that increased identification and treatment, as measured by substantial increases in the rates of hospitalization involving cirrhosis, may be a contributing factor. If, as suggested by hospitalization data that indicate a decreasing proportion of patients with cirrhosis die during their hospital stay, a major portion of the increase in cirrhosis admissions was for patients with less severe cases, these patients would be more responsive to treatment and would have a relatively better prognosis. The identification of contributing factors that may be responsible for the decline in cirrhosis mortality can provide support for the continuation of early diagnosis and treatment in already identified populations. The same kind of support can be extended to other population subgroups that have yet to show the same decline in cirrhosis mortality.
鉴于医院出院数据所反映的肝硬化发病率上升，本文对近年来肝硬化死亡率的下降情况进行了研究。虽然死亡率下降似乎没有单一的解释，但有观点认为，以涉及肝硬化的住院率大幅上升来衡量，识别和治疗的增加可能是一个促成因素。如果正如住院数据所表明的那样，肝硬化患者在住院期间死亡的比例下降，且肝硬化入院人数增加的很大一部分是病情较轻的患者，那么这些患者对治疗的反应会更好，预后也相对较好。识别可能导致肝硬化死亡率下降的促成因素，可为已确诊人群继续进行早期诊断和治疗提供支持。同样的支持也可扩展到其他尚未出现肝硬化死亡率同样下降情况的人群亚组。
