Survey of 2002 cases of liver cirrhosis: Identification of etiological factors and related complications

ObjectiveTo identify the etiologies and associated complications of liver cirrhosis for new cases emerging over the past decade in the region served by the Second Affiliated Clinical College of Chongqing University of Medical Sciences. MethodsThe institute′s inpatient medical record database was searched for all individuals admitted with a new diagnosis of liver cirrhosis between January 2002 and December 2011. Data on demographics and clinical findings were collected for retrospective analysis to determine the regional and temporal profiles of etiologies and complications. The count data, expressed as percent of total, was analyzed by the Chi-squared test. ResultsAmong the total 2002 liver cirrhosis cases, the most frequent etiologies (＞1.5% of total) were viral hepatitis type B (60.6%), fatty liver caused by both hepatitis B virus (HBV) and alcohol (16.6%), alcoholic fatty liver (6.6%), autoimmune liver disease (3.4%), autoimmune liver disease and alcohol (3.2%), and nonalcoholic fatty liver (1.7%). From the first half of the decade to the second half (January 2002-December 2006 vs. January 2007-December 2011), the incidences of two etiologies significantly increased (HBV and alcohol: 13.6% vs. 17.7%, P＜0.05 and autoimmune liver disease: 3.5% vs. 7.1%, P＜0.05) and the incidence of HBV significantly decreased (641% vs. 59.3%, P＜0.05). The most common major complications of cirrhosis were primary hepatocellular carcinoma (HCC; 221%), spontaneous peritonitis (21.3%), upper gastrointestinal bleeding (193%), hepatic encephalopathy (7.3%), and hepatorenal syndrome (4.0%). The incidence of liver cancer was significantly higher in patients with a family history of hepatitis B (31.1% vs. 222%, P＜0.05) and positively correlated with HBV DNA load (χ2 = 10.88, P＜0.05). ConclusionIn Chongqing, HBV remains a major cause of cirrhosis, even though alcoholism and autoimmune disease are rising in importance as etiological factors, and HCC is still the major complication of liver cirrhosis. The public health strategies in this region should continue to target prevention of HBV infection and diagnosis/treatment of HCC in early stages.