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- Title
Updates in characteristics and survival rates of cirrhosis in a nationwide cohort of real‐world U.S. patients, 2003–2021.
- Authors
Tran, Sally; Zou, Biyao; Lee, KeeSeok; Kam, Leslie; Yeo, YeeHui; Henry, Linda; Cheung, Ramsey; Nguyen, Mindie H.
- Abstract
Summary: Background: Adverse outcomes of cirrhosis remain a top priority. Aims: We examined the distribution of cirrhosis causes, HCC incidence and mortality and related changes over time in a nationwide U.S. cohort. Methods: A retrospective study of a national sample of commercially insured patients with cirrhosis from Optum's de‐identified Clinformatics® Data Mart Database (CDM). Results: A total of 628,743 cirrhosis cases were identified with 45% having NAFLD, 19.5% HCV, and 16.3% ALD. African Americans had the highest rate of decompensation (60.6%), while Asians had the highest rate of HCC (2.4%), both p < 0.001. African Americans more frequently had HCV (28.4%) while Hispanic/Latinos more frequently had NAFLD (49.2%, p < 0.001). Patients in the 2014–2021 cohort were significantly older (63.0 ± 12.8 vs. 57.0 ± 14.3), less frequently decompensated (54.5% vs. 58.3%) but more frequently had HCC (1.7% vs. 0.6%) and NAFLD (46.5% vs. 44.2%), all p < 0.001. The overall annual incidence of HCC was 0.76% (95% CI: 0.75–0.77) with a 5‐year cumulative incidence of 4.03% (95% CI: 3.98–4.09), with significant variation by sex, race/ethnicity, and cirrhosis aetiology. The overall median years of survival were 11.4 (95% CI: 11.3–11.5) with a 5‐year cumulative survival of 73.4% (95% CI: 73.3%–73.6%), also with significant disparities in similar subgroups (lowest in cryptogenic cirrhosis and worse in 2014–2021 vs. 2003–2013). The 2014–2021 period was independently associated with worse survival (aHR: 1.14, 95% CI: 1.08–1.20). Conclusions: HCC incidence and survival vary by aetiology among patients with cirrhosis, with cryptogenic cirrhosis having the lowest survival and lower survival in the more recent time period.
- Subjects
CIRRHOSIS of the liver; SURVIVAL rate; RACE; AFRICAN Americans; DATABASES
- Publication
Alimentary Pharmacology & Therapeutics, 2024, Vol 60, Issue 2, p212
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.18024