Background@#
Liver cirrhosis has become a heavy burden not only for
patients, but also for our society. However, little is known about the recent changes in clinical outcomes and characteristics of
patients with
cirrhosis-related
complications in
Korea. Therefore, we aimed to evaluate changes in characteristics of
patients with
liver cirrhosis in Daegu-Gyeongbuk province in
Korea over the past 15 years. @*
Methods@#We retrospectively reviewed the
medical records of 15,716
liver cirrhotic
patients from 5
university hospitals in Daegu-Gyeongbuk province from 2000 to 2014. The Korean Standard
Classification of
Diseases-6 code associated with
cirrhosis was investigated through
medical records and classified according to the year of first visit. @*Results@#A total of 15,716
patients was diagnosed with
cirrhosis. A number of
patients newly diagnosed with
cirrhosis has decreased each year. In 2000,
patients were most likely to be diagnosed with
hepatitis B virus (HBV)
cirrhosis, followed by
alcoholic cirrhosis. There was a significant decrease in HBV (P < 0.001), but alcohol,
hepatitis C virus (HCV), and
non-alcoholic fatty liver disease (
NAFLD) showed a significant increase during the study period (alcohol, P = 0.036; HCV, P = 0.001;
NAFLD, P = 0.001). At the
time of initial
diagnosis, the ratio of
Child-Turcotte-Pugh (
CTP) class A gradually increased from 23.1% to 32.9% (P < 0.001). The most common cause of
liver-related
hospitalization in 2000 was
hepatocellular carcinoma (HCC) (25.5%); in 2014, gastrointestinal
bleeding with
esophageal and gastric varices (21.4%) was the most common cause. Cases of
hospitalization with
liver-related complication represented 76.4% of all cases in 2000 but 70.9% in 2014.
Incidence rate of HCC has recently increased. In addition, HCC-free
survival was significantly lower in
CTP class A than in classes B and C. Finally, there was significant difference in HCC occurrence according to causes (P < 0.001). HBV and HCV
cirrhosis had lower HCC-free
survival than
alcoholic and
NAFLD cirrhosis. @*Conclusion@#In recent years, the overall number of
cirrhosis patients has decreased. This study confirmed the recent trend in decrease of
cirrhosis, especially of
cirrhosis due to HBV, and the increase of HCV,
alcoholic and
NAFLD cirrhosis. Targeted
screening for at-
risk patients will facilitate early
detection of
liver diseases allowing effective intervention and may have decreased the development of
cirrhosis and its
complications.