Table 4. Temporal Trends in Clinical Outcomes.
| Outcome by Cause of Cirrhosis | Incidence Rate (95% CI) per 100 Person-Years | HR or SHR (95% CI) | |||
|---|---|---|---|---|---|
| 2004-2006 | 2007-2011 | 2012-2014 | Crude | Adjusteda | |
| Mortality | 11.7 (11.0-12.4) | 11.0 (10.5-11.6) | 9.9 (9.0-10.8) | 0.90 (0.89-0.91) | 0.87 (0.86-0.88) |
| Alcohol | 10.3 (9.2-11.5) | 9.2 (8.4-10.1) | 8.2 (7.0-9.6) | 0.89 (0.87-0.91) | 0.86 (0.84-0.88) |
| Viral | 9.4 (8.5-10.4) | 9.8 (9.0-10.6) | 9.0 (7.7-10.5) | 0.93 (0.91-0.95) | 0.90 (0.88-0.92) |
| NASH or other | 22.1 (19.7-24.8) | 18.2 (16.6-19.9) | 15.2 (12.9-17.8) | 0.87 (0.85-0.88) | 0.84 (0.82-0.86) |
| Autoimmune or cholestatic | 12.3 (8.6-17.7) | 8.7 (6.1-12.4) | 6.3 (3.1-12.5) | 0.84 (0.77-0.91) | 0.84 (0.76-0.92) |
| Transplant | 0.3 (0.2-0.5) | 0.3 (0.2-0.4) | 0.3 (0.2-0.5) | 0.90 (0.84-0.97) | 0.88 (0.81-0.94) |
| Alcohol | 0.3 (0.1-0.6) | 0.4 (0.3-0.7) | 0.3 (0.1-0.7) | 0.93 (0.84-1.03) | 0.92 (0.83-1.03) |
| Viral | 0.4 (0.2-0.6) | 0.2 (0.2-0.4) | 0.3 (0.2-0.8) | 0.89 (0.79-1.01) | 0.86 (0.76-0.98) |
| NASH or other | 0.2 (0.0-0.6) | 0.2 (0.1-0.4) | 0.0 (0.0-0.0) | 0.81 (0.65-1.01) | NAb |
| Autoimmune or cholestatic | 0.8 (0.2-3.3) | 1.4 (0.6-3.5) | 0.8 (0.1-5.6) | 0.92 (0.76-1.12) | 1.04 (0.74-1.46) |
| Hepatocellular carcinoma | 1.6 (1.4-1.9) | 1.8 (1.6-2.1) | 1.8 (1.4-2.3) | 1.01 (0.97-1.04) | 1.01 (0.98-1.05) |
| Alcohol | 1.1 (0.7-1.6) | 0.9 (0.6-1.2) | 1.0 (0.6-1.8) | 0.96 (0.88-1.04) | 0.96 (0.87-1.05) |
| Viral | 2.3 (1.9-2.9) | 2.9 (2.5-3.4) | 3.1 (2.3-4.3) | 1.03 (0.99-1.08) | 1.03 (0.99-1.07) |
| NASH or other | 0.6 (0.3-1.3) | 0.8 (0.5-1.3) | 0.8 (0.3-1.8) | 0.99 (0.88-1.12) | 0.97 (0.85-1.10) |
| Autoimmune or cholestatic | 0.5 (0.1-3.3) | 2.8 (1.4-5.6) | 2.3 (0.6-9.1) | 1.11 (0.92-1.33) | 1.11 (0.76-1.62) |
| Decompensationc | 7.7 (7.0-8.4) | 10.8 (10.1-11.5) | 15.0 (13.5-16.7) | 1.04 (1.02-1.06) | 1.04 (1.02-1.06) |
| Alcohol | 7.1 (6.0-8.4) | 11.2 (9.9-12.6) | 17.3 (14.7-20.4) | 1.06 (1.03-1.09) | 1.06 (1.02-1.09) |
| Viral | 9.3 (8.2-10.4) | 12.2 (11.2-13.4) | 15.2 (12.9-17.9) | 1.02 (1.00-1.05) | 1.02 (1.00-1.05) |
| NASH or other | 4.0 (3.0-5.5) | 6.6 (5.4-8.0) | 11.7 (9.0-15.1) | 1.06 (1.01-1.11) | 1.06 (1.01-1.12) |
| Autoimmune or cholestatic | 7.6 (4.5-12.8) | 9.5 (6.3-14.3) | 10.8 (5.4-21.7) | 1.04 (0.93-1.15) | 1.05 (0.94-1.18) |
| Ascitesc | 5.6 (5.0-6.2) | 8.3 (7.8-9.0) | 11.7 (10.4-13.1) | 1.07 (1.05-1.09) | 1.07 (1.05-1.09) |
| Alcohol | 4.8 (3.9-5.8) | 7.8 (6.8-8.9) | 13.2 (11.0-16.0) | 1.10 (1.06-1.14) | 1.10 (1.06-1.14) |
| Viral | 6.9 (6.1-7.9) | 9.9 (9.0-10.9) | 12.4 (10.3-14.8) | 1.06 (1.03-1.08) | 1.06 (1.03-1.08) |
| NASH or other | 3.2 (2.3-4.6) | 5.1 (4.1-6.4) | 8.0 (5.9-10.9) | 1.06 (1.00-1.12) | 1.07 (1.00-1.13) |
| Autoimmune or cholestatic | 4.6 (2.4-8.8) | 8.0 (5.2-12.4) | 9.5 (4.5-19.9) | 1.13 (1.01-1.28) | 1.12 (0.98-1.27) |
| Hepatic encephalopathyc | 3.6 (3.1-4.0) | 4.7 (4.2-5.1) | 5.4 (4.5-6.4) | 1.02 (1.00-1.05) | 1.02 (0.99-1.05) |
| Alcohol | 3.3 (2.6-4.2) | 5.7 (4.8-6.6) | 6.8 (5.3-8.8) | 1.06 (1.02-1.10) | 1.04 (1.00-1.09) |
| Viral | 4.3 (3.6-5.0) | 5.1 (4.5-5.8) | 5.3 (4.0-7.0) | 1.01 (0.97-1.04) | 1.01 (0.97-1.05) |
| NASH or other | 1.6 (1.0-2.6) | 1.8 (1.3-2.7) | 3.4 (2.1-5.5) | 1.01 (0.93-1.09) | 0.99 (0.90-1.09) |
| Autoimmune or cholestatic | 4.4 (2.3-8.4) | 3.4 (1.8-6.6) | 2.6 (0.7-10.5) | 0.94 (0.80-1.10) | 0.97 (0.82-1.15) |
| Variceal bleedingc | 1.6 (1.3-1.9) | 1.9 (1.7-2.3) | 2.3 (1.8-3.0) | 0.99 (0.95-1.02) | 1.00 (0.96-1.04) |
| Alcohol | 1.4 (1.0-2.0) | 2.7 (2.1-3.4) | 2.4 (1.6-3.8) | 1.02 (0.96-1.08) | 1.00 (0.94-1.07) |
| Viral | 2.1 (1.6-2.6) | 2.1 (1.7-2.6) | 2.9 (2.0-4.2) | 0.96 (0.91-1.01) | 0.97 (0.92-1.03) |
| NASH or other | 0.2 (0.0-0.8) | 0.5 (0.3-1.0) | 1.4 (0.7-2.9) | 1.14 (0.96-1.36) | 1.20 (0.97-1.47) |
| Autoimmune or cholestatic | 1.5 (0.5-4.7) | 0.4 (0.1-2.6) | 0.0 (0.0-0.0) | 0.77 (0.38-1.56) | NAb |
Abbreviations: HR, hazard ratio; NA, not applicable; NASH, nonalcoholic steatohepatitis; SHR, subhazard ratio.
a
Multivariable models were adjusted for sex, cirrhosis cause, decompensation, Charlson comorbidity index, insurance, and year of cohort entry. For the mortality outcomes, HRs are reported; for other outcomes, SHRs are reported. The HRs and SHRs refer to the relative changes per year.
b
Adjusted values could not be calculated because of the small number of outcomes.
c
Decompensation outcomes were assessed only in those with compensated cirrhosis at baseline.