J Korean Med Sci.  2003 Dec;18(6):833-841. 10.3346/jkms.2003.18.6.833.

The Prognosis of Liver Cirrhosis in Recent Years in Korea

• Kim YS
• Um SH
• Ryu HS
• Lee JB
• Lee JW
• Park DK
• Kim YS
• Jin YT
• Chun HJ
• Lee HS
• Lee SW
• Choi JH
• Kim CD
• Hyun JH

• KMID: 1086740
• DOI: http://doi.org/10.3346/jkms.2003.18.6.833

Abstract

The survival of a recent series of 823 cirrhosis patients who were followed up for a mean of 48 months was analyzed. Cirrhosis was ascribed to alcohol (26%), hepatitis virus B (58%), hepatitis virus C (11%) or both (2%), or was cryptogenic (3%). Features of decompensation were observed in 51% of the patients at entry, and newly developed in 44% of compensated patients within 5 yr. The 5-yr survival after decompensation was 25%. The leading causes of death were liver failure (53%), hepatocellular carcinoma (HCC, 23%), and variceal bleeding (10%). Early detection of HCC significantly improved the survival of cirrhosis patients. Biannual ultrasonography increased the detection rate of small HCC. Mortality of variceal hemorrhage was much lower in patients with Child-Pugh scores from 5 to 8 than in those with scores above 8 (5% vs. 52%). Endoscopic prophylaxis significantly decreased the incidence of first variceal hemorrhage, but the effect was insufficient to improve the rate of survival. Mortality of first spontaneous bacterial peritonitis was 18%. These data suggest that the mortality of major complications of liver cirrhosis has considerably decreased during the last two decades, while there was no remarkable improvement in long-term survival. More efficient management of etiologic factors would be required.

Keyword

Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Prognosis; Survival Rate; Survival Analysis; Carcinoma, Hepatocellular; Esophageal and Gastric Varices; Hemorrhage

MeSH Terms

Adult
Aged
Carcinoma, Hepatocellular/etiology/physiopathology
Female
Gastrointestinal Hemorrhage
Human
Korea
Liver Cirrhosis/complications/*diagnosis/mortality/*physiopathology
Liver Neoplasms/etiology/pathology
Male
Middle Aged
Peritonitis
Prognosis
Retrospective Studies
*Survival Analysis
Survival Rate