目的:没有关于共病患病率的数据(即,关于索引疾病的其他条件)和多发病率(即,在肝硬化患者中,没有人优先考虑多种疾病的同时发生)。我们试图根据肝硬化的病因确定合并症和多发病之间的比率和差异。
方法:这是SanMAtteo复杂性(SMAC)研究的子分析。我们分析了人口统计,肝硬化患者的临床特征和合并症/多发病率取决于病因-酒精性,传染性和非酒精性脂肪性肝病(NAFLD)。对与多发病率相关的因素进行了多变量分析。
方法:单中心,在三级转诊中进行的横断面研究,学术,意大利北部内科病房(2017年11月-2019年11月)。
方法:评估了先前参加SMAC研究的1433名患者的数据;最终仅包括肝硬化患者。
结果:在1433名患者中,172(中位年龄79岁,IQR67-84;83名女性)患有肝硬化。肝硬化患者显示较高的中位累积疾病评定量表(CIRS)合并症(4,IQR3-5;p=0.01)和严重程度(1.85,IQR16。-2.0;p<0.001)指数和较低的教育水平(103,59.9%;p=0.003)。酒精性肝硬化患者明显年轻(中位数为65岁,IQR56-79)比其他病因肝硬化患者(p<0.001)和更常见的男性(25,75.8%)。合并症在酒精性肝硬化患者中更为普遍(13,39.4%),多发病率在病毒性肝硬化(64,81.0%)和NAFLD(52,86.7%)中更为普遍(p=0.015)。在与多发病率相关的因素的多变量模型中,aCIRS合并症指数>3(OR2.81,95%CI1.14至6.93,p=0.024)和与肝硬化相关的入院(OR0.19,95%CI0.07至0.54,p=0.002)是唯一的显着关联。
结论:与其他病因相比,合并症在酒精肝硬化中更为常见,内科设置。
OBJECTIVE: There are no data regarding the prevalence of comorbidity (ie, additional conditions in reference to an index disease) and multimorbidity (ie, co-occurrence of multiple diseases in which no one holds priority) in patients with liver cirrhosis. We sought to determine the rate and differences between comorbidity and multimorbidity depending on the aetiology of cirrhosis.
METHODS: This is a subanalysis of the San MAtteo Complexity (SMAC) study. We have analysed demographic, clinical characteristics and rate of comorbidity/multimorbidity of patients with liver cirrhosis depending on the aetiology-alcoholic, infectious and non-alcoholic fatty liver disease (NAFLD). A multivariable analysis for factors associated with multimorbidity was fitted.
METHODS: Single-centre, cross-sectional study conducted in a tertiary referral, academic, internal medicine ward in northern Italy (November 2017-November 2019).
METHODS: Data from 1433 patients previously enrolled in the SMAC study were assessed; only those with liver cirrhosis were eventually included.
RESULTS: Of the 1433 patients, 172 (median age 79 years, IQR 67-84; 83 females) had liver cirrhosis. Patients with cirrhosis displayed higher median Cumulative Illness Rating Scale (CIRS) comorbidity (4, IQR 3-5; p=0.01) and severity (1.85, IQR 16.-2.0; p<0.001) indexes and lower educational level (103, 59.9%; p=0.003). Patients with alcohol cirrhosis were significantly younger (median 65 years, IQR 56-79) than patients with cirrhosis of other aetiologies (p<0.001) and more commonly males (25, 75.8%). Comorbidity was more prevalent in patients with alcohol cirrhosis (13, 39.4%) and multimorbidity was more prevalent in viral (64, 81.0%) and NAFLD (52, 86.7%) cirrhosis (p=0.015). In a multivariable model for factors associated with multimorbidity, a CIRS comorbidity index >3 (OR 2.81, 95% CI 1.14 to 6.93, p=0.024) and admission related to cirrhosis (OR 0.19, 95% CI 0.07 to 0.54, p=0.002) were the only significant associations.
CONCLUSIONS: Comorbidity is more common in alcohol cirrhosis compared with other aetiologies in a hospital, internal medicine setting.