Evaluation of comorbidity in patients with alcoholic cirrhosis of the liver associated with non-alcoholic fatty liver disease
DOI:
https://doi.org/10.14739/2310-1210.2020.2.200574Keywords:
alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, comorbidityAbstract
The aim of the study was to evaluate the concomitant pathology in patients with alcoholic cirrhosis of the liver associated with non-alcoholic fatty liver disease, depending on the compensation of the disease and patient's age.
Material and methods of research. The study included 204 patients. Among them, 78 patients (Group I) had alcoholic liver cirrhosis (ALC) and 126 patients (Group II) had a combination of ALC with non-alcoholic fatty liver disease (NAFLD). Patients were subgrouped according to compensation classes by the Child-Pugh score (A, B, C). To evaluate comorbidity, CirCom, CCI, ECI indices were used.
Results. More than 70 % of patients of group II had concomitant diseases (CD) and cardiovascular complications. They also suffered from pleurisy, pneumonia, spontaneous bacterial peritonitis more frequently. 46 % of patients of groups ІІА+B, who were less than 45 years old, had two CD, which 2.6 times exceeded the number of such persons in group І. More than 80 % of middle-aged patients in group IIA+B had more than 3 CD, which is 1.7 times more than in group І. 70 % of patients of group II at the stage of decompensation of cirrhosis had 5 or more CD. The direct relationship between the age of patients and the number of CD, as well as between the degree of compensation and the amount of CD leads to a more severe course of the disease in people of group II. The significant correlation between the CCI, ECI, CirCom scales and the Child–Pugh degree of the disease severity was detected. The number of concomitant pathologies in patients suffering from liver cirrhosis (LC) significantly increased the risk of death from the causes which are not related to LC (RR: 5.872; 95 % CI: 1.866–18.477). 4-year observation showed that 80.6 % patients of group II have died, which 4 times exceeded the number of those who had ALC.
Conclusions. Most patients of group II had cardiovascular diseases. They had disorders of the respiratory, urinary, endocrine, nervous systems, as well as bacterial complications, more frequently. It is useful to use the CCI, ECI, CirCom scales of comorbidity, and Child-Pugh degree of the disease severity in considering the comorbidity level and severity of the disease. The incidence of CD increases with age and significantly increases the risk of death from causes which are not associated with the complications of the LC.
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