Prognosis of patients with a diagnosis of fatty liver--a registry-based cohort study

BACKGROUND/AIMS: There are very limited data available regarding the prognosis of patients with fatty liver. We examined the overall and cause-specific mortality of fatty liver patients in a large Danish cohort. METHODOLOGY: In the Danish National Registry of Patients, we identified 7,372 patients discharged with a diagnosis of fatty liver from a Danish hospital between 1977 and 1993. Causes of death were identified in the Danish Death Registry. We estimated the standardized mortality ratio by comparing with the general population. RESULTS: Most patients (76%) had alcoholic fatty liver. During follow-up, 2,914 (40%) died. The commonest cause of death was hepatobiliary disease (25% of deaths). Mortality was increased 5.4-fold (95% CI 5.2-5.6) in patients with alcoholic fatty liver, and 2.6-fold (95% CI 2.4-2.9) in patients with non-alcoholic or unspecified fatty liver. Overall, in the first year of follow-up, mortality was increased more than 7-fold, almost 5-fold in the second to fifth years, and more than 3-fold after that. Mortality was similar among genders and among diabetics and non-diabetics, and remained increased after censoring patients upon diagnosis of liver cirrhosis. CONCLUSIONS: The mortality of patients with a hospital discharge diagnosis of fatty liver was higher than that of the general population.