Survival in cirrhosis

BACKGROUND: Assessment of prognosis in patients with cirrhosis is important so as to plan their management. AIM: To determine the survival rates and to identify indicators associated with shorter life expectancy in Tunisians patients with cirrhosis. METHODS: This is a retrospective study of in-patients with cirrhosis during a 5-years period. We studied clinical and biochemical characteristics of all patients and the occurrence of decompensation or complication. The overall survival, mortality rate and causes of death were reviewed. Univariate and multivariate analysis was performed on all variables to identify parameters associated with a lower life expectancy. RESULTS: We studied 222 patients (60% females) with a mean age of 60 years. Mean follow up was 22 months. The overall survival was 52.5% at 5 years. With univariate analysis, 10 variables were associated with a poor prognosis: male gender, decompensation at admission, Child-Pugh C, esophageal varices, hypertensive gastropathy, occurrence of spontaneous bacterial peritonitis, hepatic encephalopathy, hepato-renal syndrome, hepatocellular carcinoma and portal thrombosis. With multivariate analysis, only male gender was independently correlated with survival. CONCLUSION: In our study, male gender was an uncommon parameter that predicts survival in cirrhotic patient. The Child-Pugh score was a good index for assessing the prognosis.