The Influence of Gender and Age on the Survival of Patients With Cirrhosis of the Liver

Abstract

According to the literature, the male sex is associated in some studies with greater mortality in CL, and in another with less. In other studies, the relationship of gender with prognosis has not been established, therefore it is not taken into account in the prognostic models of the CLU. According to the literature, the male sex is associated in some studies with greater mortality in CL, and in another with less.However, in the more widely used universal models − Child-Pugh and MELD − age is not taken into account, and this does not make them less valuable for prediction.

Objective: to study the effect of gender and age on the survival of patients with cirrhosis of the liver of viral and alcoholic etiology.

Material and methods of research: To achieve this goal, we conducted an observational, prospective (cohort) study involving 249 patients with CL of viral (B, C, B +C), alcoholic and mixed (alcohol-viral) etiology with an assessment of the final solid point – the onset of death from CL or its complications. The age of patients is from 17 to 75 years (Me=50 years), 114 men (group 1) and 135 women (group 2). The diagnosis of CL was confirmed morphologically (laparoscopy with biopsy) in 45 patients, in the rest − based on the presence of signs of diffuse liver damage, the presence of hepatic cell insufficiency syndrome and portal hypertension syndrome (varicose veins of the stomach and esophagus, ascites).

Research results and discussion: When analyzing the survival rate of CL patients in groups of men and women who were comparable in age and Child-Pugh classes, no statistically significant differences were revealed. However, when comparing the survival rates of men and women within the Child-Pugh CL classes, statistically significant differences were revealed (Kaplan–Mayer method, Gehan–Wilcoxon test, p=0.014) in patients with Child-Pugh class C CL, which began to be determined from 3 months of follow-up. Conclusions: With decompensated cirrhosis of the liver (Child-Pugh class C), the chances of death in men are 2.2 times higher than in women. Age, as an independent value from other data, did not show itself as a prognostic factor of survival during 47 months of follow-up for cirrhosis of the liver of viral and alcoholic etiology.