Main Causes of Death in Cirrhosis

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Abstract
The main causes of 436 deaths among 532 patients with cirrhosis followed up for up to 16 yr constituted liver failure (24%), liver failure with gastrointestinal bleeding (13%), gastrointestinal bleeding (14%), primary liver cell carcinoma (4%), other liver-related causes (2%), infections (7%), cardiovascular diseases (22%), extrahepatic malignancies (9%) and other non-liver-related causes (5%). Totally, 57% died of liver-related causes. A high frequency of liver-related death was found among patients with a short observation time, high biochemical activity, pronounced change in liver architecture, ascites and other signs of a poor prognosis at the time of diagnosis. The findings favored the hypothesis that cirrhosis of the liver is a disease with an initial active and a subsequent inactive phase. Half of the patients were treated with prednisone, but this had no detectable influence on the distribution of causes of or on the frequency of single causes of death as infections or gastrointestinal bleeding. The group of patients responding favorably to prednisone treatment with regard to survival (nonalcoholic women without ascites) showed causes of death not different from those of the total material.