Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study

Tzu-Wei Yang, Chi-Chih Wang, Ming-Chang Tsai, Yao-Tung Wang, Ming-Hseng Tseng and Chun-Che Lin
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Tzu-Wei Yang: School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Chi-Chih Wang: School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Ming-Chang Tsai: School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Yao-Tung Wang: School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Ming-Hseng Tseng: Department of Medical Informatics, Chung Shan Medical University, Taichung 402, Taiwan
Chun-Che Lin: Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan

IJERPH, 2020, vol. 17, issue 8, 1-10

Abstract: The prognosis of different etiologies of liver cirrhosis (LC) is not well understood. Previous studies performed on alcoholic LC-dominated cohorts have demonstrated a few conflicting results. We aimed to compare the outcome and the effect of comorbidities on survival between alcoholic and non-alcoholic LC in a viral hepatitis-dominated LC cohort. We identified newly diagnosed alcoholic and non-alcoholic LC patients, aged ≥40 years old, between 2006 and 2011, by using the Longitudinal Health Insurance Database. The hazard ratios (HRs) were calculated using the Cox proportional hazards model and the Kaplan–Meier method. A total of 472 alcoholic LC and 4313 non-alcoholic LC patients were identified in our study cohort. We found that alcoholic LC patients were predominantly male (94.7% of alcoholic LC and 62.6% of non-alcoholic LC patients were male) and younger (78.8% of alcoholic LC and 37.4% of non-alcoholic LC patients were less than 60 years old) compared with non-alcoholic LC patients. Non-alcoholic LC patients had a higher rate of concomitant comorbidities than alcoholic LC patients (79.6% vs. 68.6%, p < 0.001). LC patients with chronic kidney disease demonstrated the highest adjusted HRs of 2.762 in alcoholic LC and 1.751 in non-alcoholic LC (all p < 0.001). In contrast, LC patients with hypertension and hyperlipidemia had a decreased risk of mortality. The six-year survival rates showed no difference between both study groups ( p = 0.312). In conclusion, alcoholic LC patients were younger and had lower rates of concomitant comorbidities compared with non-alcoholic LC patients. However, all-cause mortality was not different between alcoholic and non-alcoholic LC patients.

Keywords: alcoholic liver cirrhosis; non-alcoholic liver cirrhosis; survival; comorbidity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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