Clinical outcomes of cryptogenic compared with non-cryptogenic cirrhosis: A retrospective cohort study

J Gastroenterol Hepatol. 2015 Sep;30(9):1423-8. doi: 10.1111/jgh.12978.

Abstract

Background and aim: The consequences of the association between the metabolic syndrome and cryptogenic cirrhosis are uncertain. We aimed to compare the differences in clinical outcomes between cryptogenic and non-cryptogenic cirrhosis.

Methods: A retrospective cohort study was conducted in a large, single academic center, over a 5-year duration.

Results: Complete data were available in 301 patients with cirrhosis (cryptogenic n = 94, non-cryptogenic n = 207). Compared with non-cryptogenic cirrhosis, patients with cryptogenic cirrhosis were older (mean age 66.4 ± 12.5 vs 60.7 ± 11.3 years, P < 0.0001), had more females (43.6% vs 26.6%, P = 0.003), had less disease severity (Child-Pugh C 8.5% vs 15.9%, P = 0.042), and had a higher prevalence of the metabolic syndrome (83% vs 51.2%, P < 0.0001). During the 5-year period, adults with cryptogenic Child-Pugh A cirrhosis had a longer total hospital admission duration compared with non-cryptogenic cirrhosis (median 7.0 vs 3.0 days, P = 0.035), but this was less evident in patients with more advanced disease. This difference was due to a longer duration of hospitalization for non-liver-related morbidity (median 14.0 days vs 8.0 days, P = 0.04), rather than liver-related morbidity (median 10.5 days vs 8.0 days, P = 0.34), in patients with cryptogenic compared with non-cryptogenic cirrhosis. Kaplan-Meier survival analysis showed no significant differences in survival between both types of cirrhosis for all grades of severity.

Conclusions: Cryptogenic cirrhosis is associated with a longer duration of hospitalization compared with non-cryptogenic cirrhosis at an early stage of the disease. This difference is due to a greater burden of non-liver-related complications in the former.

Keywords: clinical burden; cryptogenic cirrhosis; metabolic syndrome; non-alcoholic fatty liver disease.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Cohort Studies
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / mortality
  • Male
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Morbidity
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Sex Factors
  • Survival Rate
  • Time Factors