Study of liver cirrhosis over twenty consecutive years in adults in Southern China

Figure 1 Flowchart of the study population selection. A total of 33143 patients were finally included in the study out of 35465 patients diagnosed with liver cirrhosis from 2001 to 2020. ¹Detailed patient selection was elaborated in our previous study[8].

Figure 2 Trend in the mean age of the study population in 2001-2020. The three-year moving averages in ages were calculated and shown. The mean age of cirrhotic patients increased continuously over the 20-year study period, with a high coefficient of determination in linear regression (R² = 0.764). The three-year moving averages were plotted on the central year, as the year of diagnosis in the horizontal axis (e.g. 2002 represented 2001-2003, and 2019 represented 2018-2020).

Figure 3 Temporal trends of viral hepatitis and other major etiologies in 2001-2020. The proportion of hepatitis B virus-liver cirrhosis (HBV-LC) decreased dramatically during the 2001-2010 period but fluctuated and decreased slightly during the 2011-2020 period. Meanwhile, proportions of alcoholic-LC and autoimmune or cholestatic-LC have increased during the 20-year period. Hepatitis C virus (HCV)-LC and (HBV + HCV)-LC have not shown explicit trends. The Cochran-Armitage test for P trend found no statistical significance (P > 0.05) when comparing proportions in separated years (P > 0.05). HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Figure 4 Temporal trends in different age groups of the study population. A: In the whole population, the proportion of patients ≤ 40 years was decreasing (21.2% in 2001 to 15.7% in 2020), and those aged 41-65 years and > 65 years were increasing (65.6% in 2001 to 69.6% in 2020, and 13.3% in 2001 to 14.7% in 2020, respectively) during the 20-year study period; B: In patients with hepatitis B virus-liver cirrhosis, the proportion ≤ 40 years decreased (22.0% in 2001 to 15.1% in 2020), and those aged 41-65 years and > 65 years increased (65.8% in 2001 to 70.1% in 2020, and 12.3% in 2001 to 14.8% in 2020, respectively) during the 20-year study period.