CIRRHOSIS OF LIVER - CLINICAL COURSE IN 2,377 PATIENTS AT SAN FRANCISCO GENERAL HOSPITAL

  • 1 January 1961
    • journal article
    • research article
    • Vol. 94  (6) , 353-+
Abstract
The records of 2377 patients with Laennec''s cirrhosis were reviewed for the period 1947-1957. The chief presenting symptom was ascites in 46%, bleeding in 23%, coma in 18%, jaundice in 9%,, and both jaundice and ascites in 4%. Nearly half of the patients died during the period under study- one-third from hepatic failure, one-third from gastrointestinal bleeding, and one-third from other causes, most of which were related to alcoholism. Of those presumed to be bleeding from eso-phageal varices, 64% died at the 1st hemorrhage and 10% at subsequent hemorrhages; 85% of all those who bled from varices were dead at the end of one year, and 91% were dead at the end of 3 years. The three-year survival in the good risk group was 47%,; for the group as a whole it was 30%,. The difference in mortality rate was primarily due to an increased number of deaths from hepatic failure in the combined group, whereas 60%, of the good risk group died of recurrent gastrointestinal hemorrhage. Since so many died at the 1st hemorrhage, it was concluded that any decided improvement in the salvage rate achievable by operation must come from some means of diagnostic forecast of the likelihood of bleeding, with resort to prophylactic operation in such cases.