Decreasing Mortality Among Danish Alcoholic Cirrhosis Patients: A Nationwide Cohort Study

OBJECTIVES: Clinical management of certain cirrhosis complications has improved over the last two decades. In this study we aimed to examine whether mortality among Danish alcoholic cirrhosis patients has decreased during this period. METHODS: In this historical cohort study we used nationwide hospital data to identify Danish alcoholic cirrhosis patients diagnosed in 1996-1998, 1999-2001, 2002-2004, 2005-2007, 2008-2010, and 2011-2013. We used Cox regression to examine time trends in mortality after cirrhosis diagnosis, adjusting for confounding by age, gender, and prevalence of variceal bleeding, ascites, hepatorenal syndrome, alcoholic hepatitis, infection, hepatocellular carcinoma, comorbidity, and in-patient status at the time of cirrhosis diagnosis. RESULTS: We included 22,734 patients (69% men). The adjusted mortality hazard ratio (HR) for patients diagnosed in each period compared with those diagnosed in 1996-1998 was 0.99 (95% confidence interval (CI): 0.92-1.06) in 1999-2001, 1.00 (95% CI: 0.94-1.08) in 2002-2004, 0.97 (95% CI: 0.90-1.04) in 2005-2007, 0.94 (95% CI: 0.88-1.01) in 2008-2010, and finally 0.84 (95% CI: 0.79-0.90) in 2011-2013. CONCLUSIONS: In recent years, mortality among Danish alcoholic cirrhosis patients has decreased.