Time of first diagnosis in liver cirrhosis: what has changed over time from etiology to stage of disease?

OBJECTIVES: It was aimed to investigate the characteristics of cirrhosis etiology, stage at diagnosis, diagnostic methods, and complications with a 1-decade interval. METHODS: The clinical and demographic characteristics of patients with cirrhosis at the time of diagnosis at a tertiary university hospital between 2005-2009 (first period) and 2019-2023 (second period) were retrospectively investigated. RESULTS: In total, 1311 patients were diagnosed with cirrhosis, of which 857 (65.4%) were men. Seven hundred and ninety-eight (60.9%) were diagnosed in the first period. Six hundred and ninety (52.6%) patients were decompensated at diagnosis. Child Turcotte Pugh score was more common in the second period. MELD-Na score was higher in the first period (p = 0.026). The presentation rate with decompensation was higher in the first period (p = 0.009). In the first period, 211 (26.4%), and in the second period, 134 (26.1%) patients were diagnosed in the emergency department. The others were diagnosed in the outpatient clinic. There was no difference in the conditions for diagnosing between periods (p = 0.898). The causes of cirrhosis were, in order, 22.6% HBV, 19.7% MASLD, 18.9% cryptogenic, 13.1% ALD, 10.1% HCV, 7.7% autoimmune liver diseases, 4% HDV, 2.1% other causes, and 1.8% genetic diseases. In the second period, the frequency of cirrhosis caused by viral etiologies decreased (p < 0.05), and the frequency of MASLD and ALD increased (p < 0.05). CONCLUSION: Over the past decade, viral factors in the etiology of cirrhosis have gradually decreased, MASLD and ALD have progressively increased. While patients were detected more in compensated states, a significant portion of patients are still diagnosed in the decompensated stage and in emergency clinics.