J Korean Med Sci. 2003 Dec;18(6):833-841. English.
Published online Apr 21, 2009.
Copyright © 2003 The Korean Academy of Medical Sciences
Original Article

The Prognosis of Liver Cirrhosis in Recent Years in Korea

Young Sun Kim, Soon Ho Um, Ho Sang Ryu, Jung Bok Lee, Jae Won Lee, Dong Kyu Park, Yong Sik Kim, Yoon Tae Jin, Hoon Jai Chun, Hong Sik Lee, Sang Woo Lee, Jai Hyun Choi, Chang Duck Kim and Jin Hai Hyun
    • Institution of Digestive Disease and Nutrition, Department of Internal Medicine, College of Medicine Seoul, Korea.
    • Department of Statistics, Korea University, Seoul, Korea.

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.

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


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