TY - JOUR
T1 - Chronic liver disease in the extremely elderly of 80 years or more
T2 - Clinical characteristics, prognosis and patient survival analysis
AU - Hoshida, Yujin
AU - Ikeda, Kenji
AU - Kobayashi, Masahiro
AU - Suzuki, Yoshiyuki
AU - Tsubota, Akihito
AU - Saitoh, Satoshi
AU - Arase, Yasuji
AU - Kobayashi, Mizuho
AU - Murashima, Naoya
AU - Chayama, Kazuaki
AU - Kumada, Hiromitsu
PY - 1999/11
Y1 - 1999/11
N2 - Background/Aims: This study aimed to elucidate the clinical characteristics of patients with chronic liver disease aged 80 years or more, especially the factors affecting prognosis and carcinogenesis. Methods: A total of 135 patients aged 80 years or above were divided into chronic liver disease without cirrhosis (non-LC) and cirrhosis (LC) groups according to the severity of fibrosis, and the clinical characteristics and prognoses were evaluated. Results: Seventy-three (54.1%) of 135 patients were in the LC group and 79 patients (58.5%) had hepatitis C virus. Various concomitant diseases were seen in 122 patients (90.4%). Liver-related deaths occurred in only 19 (36.5%) of 52 patients who died during observation, although 28 patients (53.8%) had liver cancer at the time of death. Cumulative survival rates in the non-LC and the LC groups were 85.7% and 58.8% at the 5th year, and 69.4% and 19.4% at the 9th year, respectively. Cumulative liver cancer appearance rates in the non-LC and the LC groups were 1.6% and 6.1% at the 1st year, 12.4% and 19.9% at the 5th year, and 12.4% and 32.0% at the 7th year, respectively. A multivariate Cox regression analysis revealed that the presence of liver cancer (p = 0.0001), platelet count (p = 0.0242), and fibrotic stage (p = 0.0118) were independently associated with survival period, and alfa-fetoprotein (p = 0.0194) and bilirubin (p = 0.0282) were independently associated with carcinogenesis. Conclusions: Cirrhosis is the major risk factor affecting the prognosis. On the other hand, we must pay more attention to concomitant diseases specific to advanced age.
AB - Background/Aims: This study aimed to elucidate the clinical characteristics of patients with chronic liver disease aged 80 years or more, especially the factors affecting prognosis and carcinogenesis. Methods: A total of 135 patients aged 80 years or above were divided into chronic liver disease without cirrhosis (non-LC) and cirrhosis (LC) groups according to the severity of fibrosis, and the clinical characteristics and prognoses were evaluated. Results: Seventy-three (54.1%) of 135 patients were in the LC group and 79 patients (58.5%) had hepatitis C virus. Various concomitant diseases were seen in 122 patients (90.4%). Liver-related deaths occurred in only 19 (36.5%) of 52 patients who died during observation, although 28 patients (53.8%) had liver cancer at the time of death. Cumulative survival rates in the non-LC and the LC groups were 85.7% and 58.8% at the 5th year, and 69.4% and 19.4% at the 9th year, respectively. Cumulative liver cancer appearance rates in the non-LC and the LC groups were 1.6% and 6.1% at the 1st year, 12.4% and 19.9% at the 5th year, and 12.4% and 32.0% at the 7th year, respectively. A multivariate Cox regression analysis revealed that the presence of liver cancer (p = 0.0001), platelet count (p = 0.0242), and fibrotic stage (p = 0.0118) were independently associated with survival period, and alfa-fetoprotein (p = 0.0194) and bilirubin (p = 0.0282) were independently associated with carcinogenesis. Conclusions: Cirrhosis is the major risk factor affecting the prognosis. On the other hand, we must pay more attention to concomitant diseases specific to advanced age.
KW - Chronic liver disease
KW - Extremely elderly patients
KW - Liver cancer appearance rate
KW - Survival analysis
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U2 - 10.1016/S0168-8278(99)80287-6
DO - 10.1016/S0168-8278(99)80287-6
M3 - Article
C2 - 10580583
AN - SCOPUS:0032721674
SN - 0168-8278
VL - 31
SP - 860
EP - 866
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 5
ER -