Medical comorbidities and functional status limitations are determinants of mortality in many chronic diseases.
The extent to which survival in the rapidly aging cohort of patients with HCV is affected by these competing causes of mortality remains unclear.
Dr Yamini Natarajan and colleagues determined the effect of medical/functional comorbidities on survival after adjusting for liver disease severity in a cohort of patients with HCV infection.
The researchers prospectively recruited consecutive patients from an HCV clinic 2009–2014.
The team calculated an index of survival based on age, gender, medical comorbidities, and functional status variables.
The research team defined cirrhosis with the FibroSure test.
|A higher baseline Schonberg Index predicted mortality|
|Digestive Diseases & Sciences|
The researchers used multivariable Cox modeling to assess association between functional/survival measure, and survival after adjustment for severity of liver disease.
The cohort consisted of 1052 HCV patients, with an average age of 57 years of which 36% had cirrhosis.
The mean Schonberg Index was 8.2.
During a mean follow-up of 5610 person-years, the team observed that 10% of patients died.
The research team found that a higher baseline Schonberg Index predicted mortality.
The team noted that the Schonberg Index similarly predicted mortality in cirrhotic patients, and non-cirrhotic patients.
This did not change after adjusting for age, drug use, or coronary artery disease.
Dr Natarajan's team comments, "Comorbidities and functional limitations predict higher mortality in patients with HCV."
"This relationship is independent of cirrhosis."
"Use of general prognostic indices may help identify HCV patients at high risk for mortality, which could further guide clinical care in a manner not achievable with assessment of liver disease alone."