To evaluate sex-related differences in long-term overall and cause-specific mortality among adults with cirrhosis.
Approach:
Study Design: A retrospective, population-based cohort study of hospitalized patients with cirrhosis in California from 2005 to 2019.
Data Collection: Data were collected from the California Department of Health Care Access and Information linked with the California State Death Statistical Master file.
Cirrhosis Definition: Cirrhosis was defined using ICD-9-CM and ICD-10-CM codes, with specific diagnostic criteria.
Outcomes Assessment: Primary outcomes included overall and cause-specific mortality, with causes ascertained from ICD-10-CM codes.
Statistical Analysis: 1:1 greedy nearest-neighbor propensity score matching was used, with Kaplan-Meier methods and Cox proportional hazards models for mortality estimation.
Key Findings:
Current evidence on sex disparities in cirrhosis mortality is limited and conflicting.
Population-based cohorts suggest a female survival advantage, while studies of selected populations indicate disadvantages for females.
Only one cohort study has explicitly examined sex with cirrhosis mortality, suggesting no difference by sex.
Interpretation:
Limitations:
Prior studies were limited to single metropolitan areas and lacked postdischarge outcome tracking.
Insufficient stratification by disease cause and severity in previous research.
Potential misclassification of death causes and limitations in the definition of cirrhosis.
