The evaluation of complications and mortality in non-alcoholic steatohepatitis-related cirrhosis

Objectives: Cirrhosis is seen in 4-8% of patients with nonalcoholic fatty liver disease (NAFLD), and death occurs in 1-5% of them due to hepatocellular carcinoma (HCC). The aim of this study was to determine the factors associated with complications and mortality in patients with cirrhosis secondary to non-alcoholic steatohepatitis (NASH). Materials and Methods: The patients with cirrhosis due to NASH diagnosed between 2008 and 2018 in our clinic formed the study population. Patients with diabetes, obesity, or insulin resistance and those with cirrhosis due to other causes were excluded. The patients were enrolled and followed up prospectively. Results: A total of 185 patients were included in the study. The survival was 94.6% at the 1st year and 57.0% at the 5th year. Median survival duration was 5.83 years. The rate of HCC development was 0.7% at the 1st year and 9.7% at the 5th year. In the multivariate Cox analysis, age (OR: 1.12, 95% CI: 1.04-1.21; P = 0.003), creatinine (OR: 24.4, 95% CI: 2.32-257.8; P= 0.008) and encephalopathy (OR: 24.49, 95% CI: 1.06-19.6; p = 0.042) were found as independent predictors of mortality. Development of ascites occurred in 46.9%, variceal bleeding in 21.9% and encephalopathy in 18% of patients at the 5th year. Conclusion: Patients with NASH-related cirrhosis should be carefully monitored for HCC development, variceal bleeding, ascites, and encephalopathy