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Increased Age, Male Gender, and Cirrhosis, but Not Steatosis or a Positive Viral Serology, Negatively Impact the Life Expectancy of Patients who Undergo Liver Biopsy

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Abstract

Most survival studies of chronic liver disease avoid including more than one condition, often present in patients with liver disease; survival analysis of patients with liver disease in general was undertaken. Over a 9-year period, the survival experience of 365 patients who underwent liver biopsy, with a median follow-up of 3 years, was assessed. Log rank tests and Cox regression were used to evaluate risk factors. The Flemington-Harrington Gρ family of tests compared the number of deaths expected in the U.S. population in general, adjusted for age, sex, and year of biopsy, to the observed number of deaths in the patients with cirrhosis and to the observed number of deaths in patients without cirrhosis. Twenty-two (6%) patients died. Cirrhosis (HR = 2.9; 95% c.i.: 1.2–6.7), male sex (HR = 2.7; 95% c.i.: 1.1–6.6), and an additional 20 years of age at biopsy (HR = 2.9; 95% c.i:. 1.4–6.2) each negatively impacted survival. Patients with cirrhosis experienced 4.58 times the number of expected deaths (p < 0.00001). Patients without cirrhosis experienced 1.66 times the number of expected deaths (p = 0.15). Steatosis and a positive viral serology did not increase the risk of death. Male gender, increased age, and cirrhosis increased the risk of death; increased steatosis and positive viral serologic studies did not.

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References

  1. Crook PD, Jones ME, Hall AJ (2003) Mortality of hepatitis B surface antigen-positive blood donors in England and Wales. Int J Epidemiol 32:118–124

    Article  PubMed  Google Scholar 

  2. Yuen MF, Yuan HJ, Wong DK, Yuen JC, Wong WM, Chan AO et al (2005) Prognostic determinants for chronic hepatitis B in Asians: therapeutic implications. Prognostic determinants for chronic hepatitis B in Asians: therapeutic implications. Gut 54:1610–1614

    Article  PubMed  Google Scholar 

  3. Harris HE, Ramsay ME, Andrews N, Eldridge KP; HCV National Register Steering Group (2002) Hepatitis C virus. Clinical course of hepatitis C virus during the first decade of infection: cohort study. BMJ 324(7335):450–453

    Article  PubMed  Google Scholar 

  4. Pokorski RJ (2000) Long-term insured lives morbidity and mortality risk associated with chronic hepatitis C virus infection. J Insur Med 32:226–248

    PubMed  CAS  Google Scholar 

  5. Di Marco V, Lo Iacono O, Camma C, Vaccaro A, Giunta M, Martorana G et al (1999) The long-term course of chronic hepatitis B. Hepatology 30:257–264

    Article  PubMed  CAS  Google Scholar 

  6. Ong JP, Elariny H, Collantes R, Younoszai A, Chandhoke V, Reines HD et al (2005) Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obes Surg 15:310–315

    Article  PubMed  Google Scholar 

  7. Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A et al (2005) The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology 129:113–121

    Article  PubMed  Google Scholar 

  8. Marrero JA (2006) Hepatocellular carcinoma. Curr Opin Gastroenterol 22:248–253

    Article  PubMed  Google Scholar 

  9. Motola-Kuba D, Zamora-Valdes D, Uribe M, Mendez-Sanchez N (2006) Hepatocellular carcinoma. An overview. Ann Hepatol 5:16–24

    PubMed  CAS  Google Scholar 

  10. Bugianesi E (2005) Review article: steatosis, the metabolic syndrome and cancer. Aliment Pharmacol Ther 22(Suppl 2):40–43

    Article  PubMed  Google Scholar 

  11. Kojima H, Sakurai S, Matsumura M, Umemoto N, Uemura M, Morimoto H, et al (2006) Cryptogenic cirrhosis in the region where obesity is not prevalent. World J Gastroenterol 12:2080–2085

    PubMed  Google Scholar 

  12. Clark JM (2006) The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol 40(Suppl 1):S5-S10

    PubMed  Google Scholar 

  13. Bondini S, Younossi ZM (2006) Non-alcoholic fatty liver disease and hepatitis C infection. Minerva Gastroenterol Dietol 52:135–143

    PubMed  CAS  Google Scholar 

  14. Yoon EJ, Hu KO (2006) Hepatitis C virus (HCV) infection and hepatic steatosis. Int J Med Sci 3:53–56

    PubMed  Google Scholar 

  15. Bradbury MW (2006) Lipid metabolism and liver inflammation. I. Hepatic fatty acid uptake: possible role in steatosis. Am J Physiol Gastrointest Liver Physiol 290:G194-G198

    Article  PubMed  CAS  Google Scholar 

  16. Powell EE, Ali A, Clouston AD, Dixon JL, Lincoln DJ, Purdie DM, et al (2005) Steatosis is a cofactor in liver injury in hemochromatosis. Gastroenterology 129:1937–1943

    Article  PubMed  CAS  Google Scholar 

  17. Powell EE, Jonsson JR, Clouston AD (2005) Steatosis: co-factor in other liver diseases. Hepatology 42:5–13

    Article  PubMed  CAS  Google Scholar 

  18. Ziolkowski A, Wylezol M, Kukla M, Zwirska-Korczala K, Berdowska A, Pardela M et al (2005) The comparison of scoring scales for liver biopsy assessment in morbidly obese patients undergoing bariatric surgery. Obes Surg 15:1309–1314

    Article  PubMed  Google Scholar 

  19. Thomopoulos KC, Arvaniti V, Tsamantas AC, Dimitropoulou D, Gogos CA, Siagris D et al (2006) Prevalence of liver steatosis in patients with chronic hepatitis B: a study of associated factors and of relationship with fibrosis. Eur J Gastroenterol Hepatol 18:233–237

    Article  PubMed  Google Scholar 

  20. Zafrani ES (2004) Non-alcoholic fatty liver disease: an emerging pathological spectrum. Virchows Arch 444:3–12

    Article  PubMed  Google Scholar 

  21. Mann RE, Smart RG, Govoni R (2003) The epidemiology of alcoholic liver disease. Alcohol Res Health 27:209–219

    PubMed  Google Scholar 

  22. Gheorghe L, Iacob S, Simionov I, Vadan R, Gheorghe C, Iacob R et al (2005) Natural history of compensated viral B and D cirrhosis. Rom J Gastroenterol 14:329–335

    PubMed  Google Scholar 

  23. Christmas AB, Wilson AK, Franklin GA, Miller FB, Richardson JD, Rodriguez JL (2005) Cirrhosis and trauma: a deadly duo. Am Surg 71:996–1000

    PubMed  Google Scholar 

  24. Gildea TR, Cook WC, Nelson DR, Aggarwal A, Carey W, Younossi ZM et al (2004) Predictors of long-term mortality in patients with cirrhosis of the liver admitted to a medical ICU. Chest 126:1598–1603

    Article  PubMed  Google Scholar 

  25. Sanyal AJ, Banas C, Sargeant C, Luketic VA, Sterling RK, Stravitz RT (2006) Similarities and differences in outcomes of cirrhosis due to nonalcoholic steatohepatitis and hepatitis C. Hepatology 43:682–689

    Article  PubMed  Google Scholar 

  26. Yoneyama K, Taniguchi H, Kiuchi Y, Shibata Y, Mitamura K (2004) Prognostic index of liver cirrhosis with ascites with and without hepatocellular carcinoma. Scand J Gastroenterol 39:1272–1279

    Article  PubMed  CAS  Google Scholar 

  27. Schlichting P, Christensen E, Andersen PK, Fauerholdt L, Juhl E, Poulsen H et al (1983) Prognostic factors in cirrhosis identified by Cox’s regression model. Hepatology 3:889–895

    Article  PubMed  CAS  Google Scholar 

  28. D’Amico G, Morabito A, Pagliaro L, Marubini E (1986) Survival and prognostic indicators in compensated and decompensated cirrhosis. Dig Dis Sci 31:468–475

    Article  PubMed  CAS  Google Scholar 

  29. Christensen E, Schlichting P, Andersen PK, Fauerholdt L, Schou G, Pedersen BV et al (1986) Updating prognosis and therapeutic effect evaluation in cirrhosis with Cox’s multiple regression model for time-dependent variables. Scand J Gastroenterol 21:163–174

    PubMed  CAS  Google Scholar 

  30. Foreman MG, Mannino DM, Moss M (2003) Cirrhosis as a risk factor for sepsis and death: analysis of the National Hospital Discharge Survey. Chest 124:1016–1020

    Article  PubMed  Google Scholar 

  31. Cholongitas E, Senzolo M, Patch D, Kwong K, Nikolopoulou V, Leandro G et al (2006) Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit. Aliment Pharmacol Ther 23;883–893

    Article  PubMed  CAS  Google Scholar 

  32. Ravaioli M, Grazi GL, Ercolani G, Cescon M, Del Gaudio M, Zanello M et al (2006) Liver allocation for hepatocellular carcinoma: a European Center policy in the pre-MELD era. Transplantation 81:525–530

    Article  PubMed  Google Scholar 

  33. Adler M, De Gendt E, Vereerstraeten P, Degre D, Bourgeois N, Boon N et al (2005) Value of the MELD score for the assessment of pre- and post-liver transplantation survival. Transplant Proc 37:2863–2864

    Article  PubMed  CAS  Google Scholar 

  34. Ma H, Wang H, Sun Y, Guo F, Fang JL, Shao J et al (2005) [Analysis of prognosis of patients with decompensated liver cirrhosis using the criterion of the Model of End-Stage Liver Disease]. Zhonghua Gan Zang Bing Za Zhi 13:407–409

    PubMed  Google Scholar 

  35. Papatheodoridis GV, Cholongitas E, Dimitriadou E, Touloumi G, Sevastianos V, Archimandritis AJ (2005) MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis. World J Gastroenterol 11:3099–3104

    PubMed  Google Scholar 

  36. R Development Core Team (2006) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org

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Authors and Affiliations

  1. Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Mitchell S. Wachtel & Kim E. Kaye

  2. Division of Health Services Research, Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Yan Zhang

  3. Department of Immunology and Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Maurizio Chiriva-Internati

  4. Division of General Surgery, Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, 79415, USA

    Eldo E. Frezza

Authors
  1. Mitchell S. Wachtel
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  2. Yan Zhang
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  3. Kim E. Kaye
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  4. Maurizio Chiriva-Internati
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  5. Eldo E. Frezza
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Correspondence to Eldo E. Frezza.

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Wachtel, M.S., Zhang, Y., Kaye, K.E. et al. Increased Age, Male Gender, and Cirrhosis, but Not Steatosis or a Positive Viral Serology, Negatively Impact the Life Expectancy of Patients who Undergo Liver Biopsy. Dig Dis Sci 52, 2276–2281 (2007). https://doi.org/10.1007/s10620-006-9715-y

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  • DOI: https://doi.org/10.1007/s10620-006-9715-y

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