High frequency of acute decompensation and cancer in patients with compensated cirrhosis due to nonalcoholic fatty liver disease : A retrospective cohort study
Bassegoda, Octavi (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Rivera-Esteban, Jesús (Universitat Autònoma de Barcelona)
Serra Matamala, Isabel (Acadèmia de Ciències Mèdiques i de la Salut de Catalunya i de Balears)
Morillas Cunill, Rosa Ma (Universitat Autònoma de Barcelona)
Broquetas, Teresa (Hospital del Mar (Barcelona, Catalunya))
Vergara, Mercedes (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Rodriguez, Adrià (Hospital Universitari Joan XXIII de Tarragona)
Aracil, Carlos (Hospital Universitari Arnau de Vilanova)
Virolés, Silvia (Institut d'Investigació Biomèdica de Girona)
Carrión Rodríguez, José Antonio (Hospital del Mar (Barcelona, Catalunya))
Pardo, Albert (Hospital Universitari Joan XXIII de Tarragona)
Rodríguez-Tajes, Sergio (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Serra-Burriel, Miquel (University of Zurich)
Pericàs, Juan M. (Hospital Universitari Vall d'Hebron)
Augustin Recio, Salvador (Hospital Universitari Vall d'Hebron)
Ginès, Pere (Acadèmia de Ciències Mèdiques i de la Salut de Catalunya i de Balears)
Graupera, Isabel (Acadèmia de Ciències Mèdiques i de la Salut de Catalunya i de Balears)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	The natural history of compensated cirrhosis due to nonalcoholic fatty liver disease (NAFLD) has not been completely characterized. The aim of the present study was to assess the incidence and risk factors of acute decompensation of cirrhosis, hepatocellular carcinoma, and extrahepatic cancers. This was a multicenter, retrospective, cohort study including 449 patients with compensated cirrhosis due to NAFLD. We calculated cumulative incidences and used competitive risk analysis to determine the risk factors associated with decompensation and cancer development. Over a median of 39 months of follow-up, 124 patients (28%) presented acute decompensation. The most frequent decompensation was ascites (21%) followed by hepatic encephalopathy (15%), variceal bleeding (9%), and spontaneous bacterial peritonitis (3%). Acute-on-chronic liver failure was diagnosed in 6% of patients during follow-up. Liver function parameters and specifically an albumin level below 40 g/L were independently associated with an increased risk of decompensation. The presence of ischemic heart disease was independently associated with acute decompensation. Seventy-eight patients (18%) developed hepatocellular carcinoma or extrahepatic cancers during follow-up (51 and 27, respectively). Conclusion : Patients with compensated cirrhosis due to NAFLD are at high risk of severe liver complications, such as the development of acute decompensation, in a relative short follow-up time. This population is at high risk of hepatic and extrahepatic cancers. The analysis of a large contemporary cohort of 449 patients with compensated cirrhosis due to non-alcoholic fatty liver disease shows a high frequency of acute decompensations (AD) and development of cancer during 39 months of follow-up. Almost 28% of the cohort developed acute decompensation and 18% developed hepatocellular carcinoma (HCC) or extrahepatic cancer. Predictors of decompensation are mainly related to liver function and portal hypertension.
Ayudas:	Instituto de Salud Carlos III PI18/00862
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Albúmines
Publicado en:	Hepatology Communications, Vol. 6 (september 2022) , p. 3212-3222, ISSN 2471-254X

DOI: 10.1002/hep4.2056
PMID: 36073343

11 p, 987.6 KB

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