背景：老年患者的肝硬化发病率一直在增加，但有关其生存的数据有限。本研究旨在调查老年肝硬化患者与年轻患者相比的生存率和疾病进展。方法：这是一项回顾性单中心研究。纳入的患者年龄超过 50 岁，根据活检、FibroSure 测试、脾肿大和血小板低< 120 × 109/L）或包括 FibroScan 在内的影像学结果确诊为肝硬化。患有活性物质滥用、经颈静脉肝内门体分流术 (TIPS)、既往自发性细菌性腹膜炎 (SBP)、静脉曲张出血、终末期肝病模型 - Na (MELD - Na) ≥ 20、接受过肝移植、除鳞状细胞癌以外的恶性肿瘤的患者排除细胞癌和其他合并症，如充血性心力衰竭 (CHF)、慢性阻塞性肺疾病 (COPD) 和肾小球滤过率 (GFR) < 30 的终末期肾病。对肝脏诊所的患者记录进行了审查，并对人口统计、实验室、代偿和失代偿状态进行了整理。根据年龄 50-64 岁和年龄 ≥ 65 岁将患者分为两组。主要终点是死亡，次要终点是通过基线至 12 个月 MELD-Na 评分增加来衡量的疾病进展。进行 Kaplan-Meier 分析来比较两组之间的生存率。进行 Cox 回归分析以确定生存不良的独立危险因素。结果：共有191例诊断为肝硬化的患者符合纳入和排除标准。年龄50-64岁的患者80例，年龄≥65岁的患者111例。与 50-64 岁患者相比，≥65 岁患者的生存时间显着缩短（73.3 ± 4.8 对比 151.5 ± 22.7；p < .001）。诊断年龄 ≥ 65 岁 (p < 0.001)、男性 (p = .013)、体重指数 (BMI) < 30 (p = 0.005) 和失代偿 (p = 0.008) 被发现是独立危险因素生存能力差。在 12 个月的随访中，MELD-Na 评分较基线显着增加，但仅限于失代偿性肝硬化患者（p = 0.013）。结论：与年轻患者相比，年龄≥65岁的肝硬化患者的生存率明显较差。需要进行前瞻性研究来进一步调查年龄和肥胖对老年肝硬化患者的生存和疾病进展的影响。版权所有 © 2024 Khaled Al-Smadi 等人。

Background: Cirrhosis incidence in older adult patients has been increasing with limited data on their survival. This study is aimed at investigating the survival and disease progression in older adult patients with cirrhosis compared to younger patients. Methods: This is a retrospective single-center study. Patients aged above 50 with a confirmed diagnosis of cirrhosis based on biopsy, FibroSure test, splenomegaly, and low platelets < 120 × 109/L) or imaging findings including FibroScan were included. Patients with active substance abuse, transjugular intrahepatic portosystemic shunt (TIPS), prior spontaneous bacterial peritonitis (SBP), variceal hemorrhage, model for end-stage liver disease-Na (MELD - Na) ≥ 20, had liver transplantation, malignancy except for squamous cell carcinoma, and other comorbidities such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and end-stage kidney disease with glomerular filtration rate (GFR) < 30 were excluded. Patients' records from the liver clinic were reviewed and demographics, laboratory, and compensation and decompensation status were collated. Patients were separated into two groups based on age 50-64 years and age ≥ 65. The primary endpoint was death, and the secondary endpoint was disease progression measured by the baseline to 12-month increase in MELD-Na score. The Kaplan-Meier analysis was conducted to compare the survival between the two groups. Cox regression analysis was performed to identify independent risk factors for poor survival. Results: A total of 191 patients diagnosed with cirrhosis met the inclusion and exclusion criteria. There were 80 patients aged 50-64 years and 111 patients aged ≥ 65 years. Significantly shorter survival times were seen among patients aged ≥ 65 years compared to those aged 50-64 years (73.3 ± 4.8 vs. 151.5 ± 22.7; p < .001). Age of diagnosis ≥ 65 years (p < 0.001), male gender (p = .013), body mass index (BMI) < 30 (p = 0.005), and decompensation (p = 0.008) were found to be independent risk factors for poor survival. MELD-Na scores increased significantly in 12 months of follow-up from baseline, but only in patients with decompensated cirrhosis (p = 0.013). Conclusions: Cirrhotic patients aged ≥ 65 years have significantly poor survival compared to younger patients. A prospective study is needed to further investigate the effect of age and obesity on survival and disease progression in older adult patients with cirrhosis.Copyright © 2024 Khaled Al-Smadi et al.