Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis
There have been few reproducible studies of mortality in patients with autoimmune hepatitis (AIH) and its variants. We calculated mortality in a large national cohort of patients with AIH, with vs without cirrhosis, in the Netherlands. We collected data from 449 patients with established AIH (77% fe...
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| creator | van den Brand, Floris F. van der Veen, Koen S. de Boer, Ynto S. van Gerven, Nicole M. Lissenberg-Witte, Birgit I. Beuers, Ulrich van Erpecum, Karel J. van Buuren, Henk R. den Ouden, Jannie W. Brouwer, Johannus T. Vrolijk, Jan M. Verdonk, Robert C. van Hoek, Bart Koek, Ger H. Drenth, Joost P.H. Guichelaar, Marleen M.J. Mulder, Chris J.J. Bloemena, Elisabeth van Nieuwkerk, Carin M.J. Bouma, Gerd Schreuder, T.C.M.A. van der Wouden, E.J. van Meyel, J.J.M. Baak, L.C. Stadhouders, P.H.G.M. Klemt-Kropp, M. Verhagen, M.A.M.T. Bhalla, A. Kuijvenhoven, J.Ph |
| description | There have been few reproducible studies of mortality in patients with autoimmune hepatitis (AIH) and its variants. We calculated mortality in a large national cohort of patients with AIH, with vs without cirrhosis, in the Netherlands.
We collected data from 449 patients with established AIH (77% female), from 6 academic and 10 non-academic hospitals in the Netherlands. We identified 29 patients with AIH and primary biliary cholangitis and 35 patients with AIH and primary sclerosing cholangitis (AIH-PSC). Mortality and liver transplantation data were assessed from August 1, 2006 through July 31, 2016. Standardized mortality ratios (SMR) were calculated using age-, sex-, and calendar year-matched mortality for the general Dutch population.
During the 10-year follow-up period, 60 patients (13%) died (mean age, 71 years; range, 33–94 years). Twenty-six causes of death were liver related (43%), whereas the others could not be attributed to liver disease. Patients with AIH and cirrhosis had significantly higher mortality than the general population (SMR, 1.9; 95% CI, 1.2–3.4), whereas patients without cirrhosis did not (SMR, 1.2; 95% CI, 0.8–1.8). Patients with AIH-PSC had the largest increase in mortality, compared to the general population (SMR, 4.7; 95% CI, 1.5–14.6), of all groups analyzed. Mortality in patients with AIH and primary biliary cholangitis was not greater than the general population. Four or more relapses per decade or not achieving remission was associated with an increase in liver-related death or liver transplantation. Nine patients underwent liver transplantation; 2 died from non-liver related causes. Four of 9 patients on the waitlist for transplantation died before receiving a donated liver.
In an analysis of data from a large national cohort of patients with AIH, we found increased mortality of patients with cirrhosis, but not of patients without cirrhosis, compared to the general Dutch population. Survival was significantly reduced in patients with AIH and features of concurrent PSC. |
| doi_str_mv | 10.1016/j.cgh.2018.09.046 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2116843186</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1542356518310784</els_id><sourcerecordid>2116843186</sourcerecordid><originalsourceid>FETCH-LOGICAL-c396t-1a99e1ddd2376278f79b8d80e2612a07f73dea946c7f4305a2410c687b1080b23</originalsourceid><addsrcrecordid>eNp9kLtOKzEURS10Ee8PoLlyeZsMPp6JPRZVFPGSQFCAKC3HPkMcZcbB9iDx9xgll5Lq7GLtLZ1FyDmwChiIi1Vl35YVZ9BWTFWsEXvkCKYNn0gJzZ9drqdiekiOU1oxxlWj5AE5rEsCxdQRebkbbEST0NGHELNZ-_xJZ30Y3uiTyR6HnOirz0v6sb1hzHTuY1yG5BM1g6OzMQff9-OA9BY3pZN9OiX7nVknPNvdE_JyffU8v53cP97czWf3E1srkSdglEJwzvFaCi7bTqpF61qGXAA3THaydmhUI6zsmppNDW-AWdHKBbCWLXh9Qv5tdzcxvI-Ysu59srhemwHDmDQHEG1TQysKClvUxpBSxE5vou9N_NTA9LdNvdLFpv62qZnSxWbp_N3Nj4se3U_jv74CXG4BLE9-eIw62eLMovMRbdYu-F_mvwBbcoS4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2116843186</pqid></control><display><type>article</type><title>Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>van den Brand, Floris F. ; van der Veen, Koen S. ; de Boer, Ynto S. ; van Gerven, Nicole M. ; Lissenberg-Witte, Birgit I. ; Beuers, Ulrich ; van Erpecum, Karel J. ; van Buuren, Henk R. ; den Ouden, Jannie W. ; Brouwer, Johannus T. ; Vrolijk, Jan M. ; Verdonk, Robert C. ; van Hoek, Bart ; Koek, Ger H. ; Drenth, Joost P.H. ; Guichelaar, Marleen M.J. ; Mulder, Chris J.J. ; Bloemena, Elisabeth ; van Nieuwkerk, Carin M.J. ; Bouma, Gerd ; Schreuder, T.C.M.A. ; van der Wouden, E.J. ; van Meyel, J.J.M. ; Baak, L.C. ; Stadhouders, P.H.G.M. ; Klemt-Kropp, M. ; Verhagen, M.A.M.T. ; Bhalla, A. ; Kuijvenhoven, J.Ph</creator><creatorcontrib>van den Brand, Floris F. ; van der Veen, Koen S. ; de Boer, Ynto S. ; van Gerven, Nicole M. ; Lissenberg-Witte, Birgit I. ; Beuers, Ulrich ; van Erpecum, Karel J. ; van Buuren, Henk R. ; den Ouden, Jannie W. ; Brouwer, Johannus T. ; Vrolijk, Jan M. ; Verdonk, Robert C. ; van Hoek, Bart ; Koek, Ger H. ; Drenth, Joost P.H. ; Guichelaar, Marleen M.J. ; Mulder, Chris J.J. ; Bloemena, Elisabeth ; van Nieuwkerk, Carin M.J. ; Bouma, Gerd ; Schreuder, T.C.M.A. ; van der Wouden, E.J. ; van Meyel, J.J.M. ; Baak, L.C. ; Stadhouders, P.H.G.M. ; Klemt-Kropp, M. ; Verhagen, M.A.M.T. ; Bhalla, A. ; Kuijvenhoven, J.Ph ; Dutch Autoimmune Hepatitis Study Group</creatorcontrib><description>There have been few reproducible studies of mortality in patients with autoimmune hepatitis (AIH) and its variants. We calculated mortality in a large national cohort of patients with AIH, with vs without cirrhosis, in the Netherlands.
We collected data from 449 patients with established AIH (77% female), from 6 academic and 10 non-academic hospitals in the Netherlands. We identified 29 patients with AIH and primary biliary cholangitis and 35 patients with AIH and primary sclerosing cholangitis (AIH-PSC). Mortality and liver transplantation data were assessed from August 1, 2006 through July 31, 2016. Standardized mortality ratios (SMR) were calculated using age-, sex-, and calendar year-matched mortality for the general Dutch population.
During the 10-year follow-up period, 60 patients (13%) died (mean age, 71 years; range, 33–94 years). Twenty-six causes of death were liver related (43%), whereas the others could not be attributed to liver disease. Patients with AIH and cirrhosis had significantly higher mortality than the general population (SMR, 1.9; 95% CI, 1.2–3.4), whereas patients without cirrhosis did not (SMR, 1.2; 95% CI, 0.8–1.8). Patients with AIH-PSC had the largest increase in mortality, compared to the general population (SMR, 4.7; 95% CI, 1.5–14.6), of all groups analyzed. Mortality in patients with AIH and primary biliary cholangitis was not greater than the general population. Four or more relapses per decade or not achieving remission was associated with an increase in liver-related death or liver transplantation. Nine patients underwent liver transplantation; 2 died from non-liver related causes. Four of 9 patients on the waitlist for transplantation died before receiving a donated liver.
In an analysis of data from a large national cohort of patients with AIH, we found increased mortality of patients with cirrhosis, but not of patients without cirrhosis, compared to the general Dutch population. Survival was significantly reduced in patients with AIH and features of concurrent PSC.</description><identifier>ISSN: 1542-3565</identifier><identifier>EISSN: 1542-7714</identifier><identifier>DOI: 10.1016/j.cgh.2018.09.046</identifier><identifier>PMID: 30291909</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autoimmune Liver Disease ; Child ; Child, Preschool ; Female ; Hepatitis, Autoimmune - complications ; Hepatitis, Autoimmune - mortality ; Hospitals ; Humans ; Liver Cirrhosis - mortality ; Long Term ; Male ; Middle Aged ; Netherlands - epidemiology ; Outcome ; Relapse ; Remission ; Survival Analysis ; Young Adult</subject><ispartof>Clinical gastroenterology and hepatology, 2019-04, Vol.17 (5), p.940-947.e2</ispartof><rights>2019 AGA Institute</rights><rights>Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-1a99e1ddd2376278f79b8d80e2612a07f73dea946c7f4305a2410c687b1080b23</citedby><cites>FETCH-LOGICAL-c396t-1a99e1ddd2376278f79b8d80e2612a07f73dea946c7f4305a2410c687b1080b23</cites><orcidid>0000-0002-0221-9538 ; 0000-0001-6527-764X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1542356518310784$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30291909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van den Brand, Floris F.</creatorcontrib><creatorcontrib>van der Veen, Koen S.</creatorcontrib><creatorcontrib>de Boer, Ynto S.</creatorcontrib><creatorcontrib>van Gerven, Nicole M.</creatorcontrib><creatorcontrib>Lissenberg-Witte, Birgit I.</creatorcontrib><creatorcontrib>Beuers, Ulrich</creatorcontrib><creatorcontrib>van Erpecum, Karel J.</creatorcontrib><creatorcontrib>van Buuren, Henk R.</creatorcontrib><creatorcontrib>den Ouden, Jannie W.</creatorcontrib><creatorcontrib>Brouwer, Johannus T.</creatorcontrib><creatorcontrib>Vrolijk, Jan M.</creatorcontrib><creatorcontrib>Verdonk, Robert C.</creatorcontrib><creatorcontrib>van Hoek, Bart</creatorcontrib><creatorcontrib>Koek, Ger H.</creatorcontrib><creatorcontrib>Drenth, Joost P.H.</creatorcontrib><creatorcontrib>Guichelaar, Marleen M.J.</creatorcontrib><creatorcontrib>Mulder, Chris J.J.</creatorcontrib><creatorcontrib>Bloemena, Elisabeth</creatorcontrib><creatorcontrib>van Nieuwkerk, Carin M.J.</creatorcontrib><creatorcontrib>Bouma, Gerd</creatorcontrib><creatorcontrib>Schreuder, T.C.M.A.</creatorcontrib><creatorcontrib>van der Wouden, E.J.</creatorcontrib><creatorcontrib>van Meyel, J.J.M.</creatorcontrib><creatorcontrib>Baak, L.C.</creatorcontrib><creatorcontrib>Stadhouders, P.H.G.M.</creatorcontrib><creatorcontrib>Klemt-Kropp, M.</creatorcontrib><creatorcontrib>Verhagen, M.A.M.T.</creatorcontrib><creatorcontrib>Bhalla, A.</creatorcontrib><creatorcontrib>Kuijvenhoven, J.Ph</creatorcontrib><creatorcontrib>Dutch Autoimmune Hepatitis Study Group</creatorcontrib><title>Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis</title><title>Clinical gastroenterology and hepatology</title><addtitle>Clin Gastroenterol Hepatol</addtitle><description>There have been few reproducible studies of mortality in patients with autoimmune hepatitis (AIH) and its variants. We calculated mortality in a large national cohort of patients with AIH, with vs without cirrhosis, in the Netherlands.
We collected data from 449 patients with established AIH (77% female), from 6 academic and 10 non-academic hospitals in the Netherlands. We identified 29 patients with AIH and primary biliary cholangitis and 35 patients with AIH and primary sclerosing cholangitis (AIH-PSC). Mortality and liver transplantation data were assessed from August 1, 2006 through July 31, 2016. Standardized mortality ratios (SMR) were calculated using age-, sex-, and calendar year-matched mortality for the general Dutch population.
During the 10-year follow-up period, 60 patients (13%) died (mean age, 71 years; range, 33–94 years). Twenty-six causes of death were liver related (43%), whereas the others could not be attributed to liver disease. Patients with AIH and cirrhosis had significantly higher mortality than the general population (SMR, 1.9; 95% CI, 1.2–3.4), whereas patients without cirrhosis did not (SMR, 1.2; 95% CI, 0.8–1.8). Patients with AIH-PSC had the largest increase in mortality, compared to the general population (SMR, 4.7; 95% CI, 1.5–14.6), of all groups analyzed. Mortality in patients with AIH and primary biliary cholangitis was not greater than the general population. Four or more relapses per decade or not achieving remission was associated with an increase in liver-related death or liver transplantation. Nine patients underwent liver transplantation; 2 died from non-liver related causes. Four of 9 patients on the waitlist for transplantation died before receiving a donated liver.
In an analysis of data from a large national cohort of patients with AIH, we found increased mortality of patients with cirrhosis, but not of patients without cirrhosis, compared to the general Dutch population. Survival was significantly reduced in patients with AIH and features of concurrent PSC.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Autoimmune Liver Disease</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hepatitis, Autoimmune - complications</subject><subject>Hepatitis, Autoimmune - mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Liver Cirrhosis - mortality</subject><subject>Long Term</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Outcome</subject><subject>Relapse</subject><subject>Remission</subject><subject>Survival Analysis</subject><subject>Young Adult</subject><issn>1542-3565</issn><issn>1542-7714</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLtOKzEURS10Ee8PoLlyeZsMPp6JPRZVFPGSQFCAKC3HPkMcZcbB9iDx9xgll5Lq7GLtLZ1FyDmwChiIi1Vl35YVZ9BWTFWsEXvkCKYNn0gJzZ9drqdiekiOU1oxxlWj5AE5rEsCxdQRebkbbEST0NGHELNZ-_xJZ30Y3uiTyR6HnOirz0v6sb1hzHTuY1yG5BM1g6OzMQff9-OA9BY3pZN9OiX7nVknPNvdE_JyffU8v53cP97czWf3E1srkSdglEJwzvFaCi7bTqpF61qGXAA3THaydmhUI6zsmppNDW-AWdHKBbCWLXh9Qv5tdzcxvI-Ysu59srhemwHDmDQHEG1TQysKClvUxpBSxE5vou9N_NTA9LdNvdLFpv62qZnSxWbp_N3Nj4se3U_jv74CXG4BLE9-eIw62eLMovMRbdYu-F_mvwBbcoS4</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>van den Brand, Floris F.</creator><creator>van der Veen, Koen S.</creator><creator>de Boer, Ynto S.</creator><creator>van Gerven, Nicole M.</creator><creator>Lissenberg-Witte, Birgit I.</creator><creator>Beuers, Ulrich</creator><creator>van Erpecum, Karel J.</creator><creator>van Buuren, Henk R.</creator><creator>den Ouden, Jannie W.</creator><creator>Brouwer, Johannus T.</creator><creator>Vrolijk, Jan M.</creator><creator>Verdonk, Robert C.</creator><creator>van Hoek, Bart</creator><creator>Koek, Ger H.</creator><creator>Drenth, Joost P.H.</creator><creator>Guichelaar, Marleen M.J.</creator><creator>Mulder, Chris J.J.</creator><creator>Bloemena, Elisabeth</creator><creator>van Nieuwkerk, Carin M.J.</creator><creator>Bouma, Gerd</creator><creator>Schreuder, T.C.M.A.</creator><creator>van der Wouden, E.J.</creator><creator>van Meyel, J.J.M.</creator><creator>Baak, L.C.</creator><creator>Stadhouders, P.H.G.M.</creator><creator>Klemt-Kropp, M.</creator><creator>Verhagen, M.A.M.T.</creator><creator>Bhalla, A.</creator><creator>Kuijvenhoven, J.Ph</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0221-9538</orcidid><orcidid>https://orcid.org/0000-0001-6527-764X</orcidid></search><sort><creationdate>201904</creationdate><title>Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis</title><author>van den Brand, Floris F. ; van der Veen, Koen S. ; de Boer, Ynto S. ; van Gerven, Nicole M. ; Lissenberg-Witte, Birgit I. ; Beuers, Ulrich ; van Erpecum, Karel J. ; van Buuren, Henk R. ; den Ouden, Jannie W. ; Brouwer, Johannus T. ; Vrolijk, Jan M. ; Verdonk, Robert C. ; van Hoek, Bart ; Koek, Ger H. ; Drenth, Joost P.H. ; Guichelaar, Marleen M.J. ; Mulder, Chris J.J. ; Bloemena, Elisabeth ; van Nieuwkerk, Carin M.J. ; Bouma, Gerd ; Schreuder, T.C.M.A. ; van der Wouden, E.J. ; van Meyel, J.J.M. ; Baak, L.C. ; Stadhouders, P.H.G.M. ; Klemt-Kropp, M. ; Verhagen, M.A.M.T. ; Bhalla, A. ; Kuijvenhoven, J.Ph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-1a99e1ddd2376278f79b8d80e2612a07f73dea946c7f4305a2410c687b1080b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Autoimmune Liver Disease</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hepatitis, Autoimmune - complications</topic><topic>Hepatitis, Autoimmune - mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Liver Cirrhosis - mortality</topic><topic>Long Term</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands - epidemiology</topic><topic>Outcome</topic><topic>Relapse</topic><topic>Remission</topic><topic>Survival Analysis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van den Brand, Floris F.</creatorcontrib><creatorcontrib>van der Veen, Koen S.</creatorcontrib><creatorcontrib>de Boer, Ynto S.</creatorcontrib><creatorcontrib>van Gerven, Nicole M.</creatorcontrib><creatorcontrib>Lissenberg-Witte, Birgit I.</creatorcontrib><creatorcontrib>Beuers, Ulrich</creatorcontrib><creatorcontrib>van Erpecum, Karel J.</creatorcontrib><creatorcontrib>van Buuren, Henk R.</creatorcontrib><creatorcontrib>den Ouden, Jannie W.</creatorcontrib><creatorcontrib>Brouwer, Johannus T.</creatorcontrib><creatorcontrib>Vrolijk, Jan M.</creatorcontrib><creatorcontrib>Verdonk, Robert C.</creatorcontrib><creatorcontrib>van Hoek, Bart</creatorcontrib><creatorcontrib>Koek, Ger H.</creatorcontrib><creatorcontrib>Drenth, Joost P.H.</creatorcontrib><creatorcontrib>Guichelaar, Marleen M.J.</creatorcontrib><creatorcontrib>Mulder, Chris J.J.</creatorcontrib><creatorcontrib>Bloemena, Elisabeth</creatorcontrib><creatorcontrib>van Nieuwkerk, Carin M.J.</creatorcontrib><creatorcontrib>Bouma, Gerd</creatorcontrib><creatorcontrib>Schreuder, T.C.M.A.</creatorcontrib><creatorcontrib>van der Wouden, E.J.</creatorcontrib><creatorcontrib>van Meyel, J.J.M.</creatorcontrib><creatorcontrib>Baak, L.C.</creatorcontrib><creatorcontrib>Stadhouders, P.H.G.M.</creatorcontrib><creatorcontrib>Klemt-Kropp, M.</creatorcontrib><creatorcontrib>Verhagen, M.A.M.T.</creatorcontrib><creatorcontrib>Bhalla, A.</creatorcontrib><creatorcontrib>Kuijvenhoven, J.Ph</creatorcontrib><creatorcontrib>Dutch Autoimmune Hepatitis Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van den Brand, Floris F.</au><au>van der Veen, Koen S.</au><au>de Boer, Ynto S.</au><au>van Gerven, Nicole M.</au><au>Lissenberg-Witte, Birgit I.</au><au>Beuers, Ulrich</au><au>van Erpecum, Karel J.</au><au>van Buuren, Henk R.</au><au>den Ouden, Jannie W.</au><au>Brouwer, Johannus T.</au><au>Vrolijk, Jan M.</au><au>Verdonk, Robert C.</au><au>van Hoek, Bart</au><au>Koek, Ger H.</au><au>Drenth, Joost P.H.</au><au>Guichelaar, Marleen M.J.</au><au>Mulder, Chris J.J.</au><au>Bloemena, Elisabeth</au><au>van Nieuwkerk, Carin M.J.</au><au>Bouma, Gerd</au><au>Schreuder, T.C.M.A.</au><au>van der Wouden, E.J.</au><au>van Meyel, J.J.M.</au><au>Baak, L.C.</au><au>Stadhouders, P.H.G.M.</au><au>Klemt-Kropp, M.</au><au>Verhagen, M.A.M.T.</au><au>Bhalla, A.</au><au>Kuijvenhoven, J.Ph</au><aucorp>Dutch Autoimmune Hepatitis Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis</atitle><jtitle>Clinical gastroenterology and hepatology</jtitle><addtitle>Clin Gastroenterol Hepatol</addtitle><date>2019-04</date><risdate>2019</risdate><volume>17</volume><issue>5</issue><spage>940</spage><epage>947.e2</epage><pages>940-947.e2</pages><issn>1542-3565</issn><eissn>1542-7714</eissn><abstract>There have been few reproducible studies of mortality in patients with autoimmune hepatitis (AIH) and its variants. We calculated mortality in a large national cohort of patients with AIH, with vs without cirrhosis, in the Netherlands.
We collected data from 449 patients with established AIH (77% female), from 6 academic and 10 non-academic hospitals in the Netherlands. We identified 29 patients with AIH and primary biliary cholangitis and 35 patients with AIH and primary sclerosing cholangitis (AIH-PSC). Mortality and liver transplantation data were assessed from August 1, 2006 through July 31, 2016. Standardized mortality ratios (SMR) were calculated using age-, sex-, and calendar year-matched mortality for the general Dutch population.
During the 10-year follow-up period, 60 patients (13%) died (mean age, 71 years; range, 33–94 years). Twenty-six causes of death were liver related (43%), whereas the others could not be attributed to liver disease. Patients with AIH and cirrhosis had significantly higher mortality than the general population (SMR, 1.9; 95% CI, 1.2–3.4), whereas patients without cirrhosis did not (SMR, 1.2; 95% CI, 0.8–1.8). Patients with AIH-PSC had the largest increase in mortality, compared to the general population (SMR, 4.7; 95% CI, 1.5–14.6), of all groups analyzed. Mortality in patients with AIH and primary biliary cholangitis was not greater than the general population. Four or more relapses per decade or not achieving remission was associated with an increase in liver-related death or liver transplantation. Nine patients underwent liver transplantation; 2 died from non-liver related causes. Four of 9 patients on the waitlist for transplantation died before receiving a donated liver.
In an analysis of data from a large national cohort of patients with AIH, we found increased mortality of patients with cirrhosis, but not of patients without cirrhosis, compared to the general Dutch population. Survival was significantly reduced in patients with AIH and features of concurrent PSC.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30291909</pmid><doi>10.1016/j.cgh.2018.09.046</doi><orcidid>https://orcid.org/0000-0002-0221-9538</orcidid><orcidid>https://orcid.org/0000-0001-6527-764X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1542-3565 |
| ispartof | Clinical gastroenterology and hepatology, 2019-04, Vol.17 (5), p.940-947.e2 |
| issn | 1542-3565 1542-7714 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2116843186 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Autoimmune Liver Disease Child Child, Preschool Female Hepatitis, Autoimmune - complications Hepatitis, Autoimmune - mortality Hospitals Humans Liver Cirrhosis - mortality Long Term Male Middle Aged Netherlands - epidemiology Outcome Relapse Remission Survival Analysis Young Adult |
| title | Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T04%3A50%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Increased%20Mortality%20Among%20Patients%20With%20vs%20Without%20Cirrhosis%20and%20Autoimmune%20Hepatitis&rft.jtitle=Clinical%20gastroenterology%20and%20hepatology&rft.au=van%20den%20Brand,%20Floris%20F.&rft.aucorp=Dutch%20Autoimmune%20Hepatitis%20Study%20Group&rft.date=2019-04&rft.volume=17&rft.issue=5&rft.spage=940&rft.epage=947.e2&rft.pages=940-947.e2&rft.issn=1542-3565&rft.eissn=1542-7714&rft_id=info:doi/10.1016/j.cgh.2018.09.046&rft_dat=%3Cproquest_cross%3E2116843186%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2116843186&rft_id=info:pmid/30291909&rft_els_id=S1542356518310784&rfr_iscdi=true |