Rate of decompensation and clinical progression of disease in people with cirrhosis: a cohort study

Kate M Fleming (1) , Guruprasad Aithal (2) , Tim Card (1, 3) , Joe West (4)

1 Division of Epidemiology and Public Health
2 Nottingham Digestive Diseases Centre: NIHR Biomedical Research Unit
3 Gastroenterology
4 Division of Epidemiology and Public Health

We lack population-based estimates of the rate of decompensation in people with compensated cirrhosis as well as estimates of the manner in which the disease progresses once identified. To determine the rate of decompensation and clinical progression of disease in patients with cirrhosis based upon clinical symptoms recorded in general practice data. Using Cox proportional hazards regression we modelled the rate of decompensation for patients from the UK General Practice Research Database with a diagnosis of cirrhosis between 1987 and 2002. We determined the clinical progression in the first year following diagnosis and subsequently categorising patients through time according to a simple clinical staging system agreed at the Baveno IV consensus conference. The rate of decompensation in patients with compensated cirrhosis was found to be 11% overall. The rate of decompensation was higher in the first yaer (at 31% compared with 7.3% afterwards) and in patients with an alcoholic aetiology. Patients with compensated cirrhosis had a 1-year probability of proceeding directly to death of 7% compared with 20% in patients with decompensated cirrhosis. Using data recorded in general practice records it has been possible to determine the rate of decompensation and the clinical progression of disease in people with cirrhosis.

Mots clés: Medicine

Kate M Fleming, Guruprasad Aithal, Tim Card, Joe West. Rate of decompensation and clinical progression of disease in people with cirrhosis: a cohort study. Alimentary Pharmacology and Therapeutics, 2010, 32 (11-12), pp.1343. ⟨10.1111/j.1365-2036.2010.04473.x⟩. ⟨hal-00582718⟩