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( Hyun Young Woo ),( Jeong Won Jang ),( Sang Gyune Kim ),( Chang Hyeong Lee ),( Tae Yeob Kim ),( Won Young Tak ),( Sung Kyu Choi ),( Mong Cho1 ),( Jong Young Choi ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background: Cirrhosis-related complications are indications for transplantation. However, the mode of complication has not been evaluated so far. To better address this issue, we investigated the mode of cirrhosis related complication and impact of these complications on survival in prospective, multicenter, inception cohort study of subjects with liver cirrhosis presenting with the first onset of decompensated complication. Methods: In this observational study, 1515 patients with the confirmed onset time of the first decompensated complication were enrolled. The mortality risk of cirrhosis-related complications, including ascites, portal hypertensive gastrointestinal bleeding (PHGB), spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), hepatorenal syndrome (HRS), was analyzed in these cirrhotic patients. Result: As the first complication, ascites was the most frequent (53.8%), followed PHGB (36.2%), HE (7.6%), SBP (1.7%) and HRS (0.7%). During follow-up (mean 32±47 months), 484 (31.9%) experienced subsequent decompensations and the proportion of subsequent complication was consistently changed; the proportion of HE, SBP, HRS increased as time progressed. The interval between subsequent decompensative events was progressively shortened. The mortality rate according to the first complication was as follows; Ascites =PHGB> HE=SBP>HRS. The mortality rate of patients experienceing subsequent complication was significantly higher than those without subsequent complication. According to the kinds of subsequent complication, survival of HE was also higher than HRS but lower than ascites or PHGB and similar to that of SBP and this difference of survival disappeared after repeated complication. Conclusion: The mortality risk correlated with initial complication and the risk increases as the number of complication episodes is repeated. Patient`s mean age was 56±11.50 years and 72.1% was male. The cause of liver cirrhosis is hepatitis B virus (38.6%), alcohol (35.5%) and hepatitis C virus (8.9%).
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