Abstract
Background: Cirrhosis is the end-stage liver fibrosis and leads to massive death worldwide. Interstitial lung abnormalities (ILAs) have received widespread attention because of their progression to pulmonary fibrosis and mortality. This study aimed to investigate whether the presence of ILAs is associated with elevated mortality in patients with cirrhosis.
Methods: Patients diagnosed with cirrhosis between August 2011 and November 2023 were retrospectively included. Clinical data were collected from electronic records. ILAs were recorded by chest computed tomography. The proportion of ILAs and the associations between ILAs and all-cause mortality in cirrhosis were analyzed.
Results: A total of 4,022 patients with cirrhosis were included, and 749 (18.6%) subjects were diagnosed with ILAs. During the median 2.1 (1.0-5.1) years of follow-up, patients with ILAs had higher mortality than those without (48.6% vs. 38.1%; P<0.001), ILAs significantly increased all-cause mortality (hazard ratio: 1.355; 95% confidence interval: 1.202-1.527; P<0.001). These associations remain significant in patients with viral, alcoholic, and primary biliary cirrhosis. Moreover, all the imaging features of the ILAs were positively related to mortality (P<0.05). According to the subgroup analysis, these associations were consistent across age and sex but were stronger in compensated cirrhosis than decompensation (P for interaction: 0.047).
Conclusion: ILAs is high occurrence in patients with cirrhosis, is independently related to all-cause mortality in patients with cirrhosis, and strategies for risk stratification and prognosis assessment targeting ILA may yield clinical benefits.