Comorbidity in cirrhosis

Table 1 Comorbidity scoring systems for patients with cirrhosis

Target population	Charlson comorbidity index	CirCom	CCI-OLT
	Patients with any disease	Patients with cirrhosis	Orthotopic liver transplant recipients
HIV/AIDS	6
Cancer (metastatic)	6	31
Cancer (non-metastatic or hematologic)	2	11
Liver disease (mild)	1
Liver disease (severe)	3
Diabetes (no complications)	1		1
Diabetes (with complications)	2		1
Kidney disease	2	3	2
Hemiplegia	2
Peptic ulcer	1
Connective tissue disease	1		2
Chronic obstructive lung disease	1	1	3
Dementia	1
Epilepsy		1
Cerebrovascular disease	1
Peripheral vascular disease	1	1
Congestive heart failure	1	1
Acute myocardial infarction	1	11	2
Substance abuse other than alcoholism		1

¹Add two points if the comorbid disease is active. The numbers indicate the comorbid diseases’ weight. HIV: Human immunodeficiency virus; AIDS: Acquired immunodeficiency syndrome; CCI-OLT: Charlson comorbidity index for orthotopic liver transplantation.

Table 2 Effects of comorbid diseases on the mortality of patients with liver cirrhosis in the CirCom cohort of 12976 Danish cirrhosis patients. Hazard ratios are adjusted for gender and age differences[3]

Comorbidity	Hazard ratio (95%CI)
Diabetes with complications	1.16 (1.10-1.22)
Diabetes without complications	1.03 (0.98-1.08)
Acute myocardial infarction	1.59 (1.40-1.79)
Peripheral arterial disease	1.29 (1.18-1.40)
Heart failure	1.27 (1.20-1.34)
Valvular heart disease	1.17 (1.04-1.30)
Cardiomyopathy	1.16 (1.03-1.30)
Arterial hypertension with complications	1.16 (0.98-1.37)
Cardiac arrhythmia	1.14 (1.08-1.20)
Mesenteric vascular disease	1.13 (0.85-1.49)
Ischemic heart disease without myocardial infarction	1.13 (1.06-1.21)
Mesenteric vascular disease	1.13 (0.85-1.49)
Cerebrovascular disease	1.09 (1.02-1.16)
Venous thromboembolism	1.20 (1.08-1.33)
Chronic obstructive lung disease	1.24 (1.18-1.30)
Peptic ulcer with bleeding or perforation	1.17 (1.11-1.23)
Chronic pancreatitis	1.09 (1.03-1.16)
Chronic inflammatory bowel disease	1.08 (0.95-1.22)
Peptic ulcer without complications	1.03 (0.97-1.10)
Acute pancreatitis	1.01 (0.92-1.12)
Chronic kidney disease	1.59 (1.37-1.83)
Psoriasis	1.05 (0.92-1.21)
Connective tissue disease	0.99 (0.91-1.08)
Epilepsy	1.22 (1.11-1.35)
Schizophrenia	1.15 (1.00-1.32)
Bipolar disorder	0.98 (0.76-1.26)
Depression	1.00 (0.91-1.09)
Dementia	1.04 (0.95-1.15)
Substance abuse other than alcoholism	1.25 (1.14-1.37)
Metastatic cancer	1.72 (1.53-1.94)
Non-metastatic solid cancer	1.35 (1.27-1.43)
Hematologic cancer	1.30 (1.10-1.53)
Human immunodeficiency virus infection	0.79 (0.49-1.26)
Osteoporosis	1.03 (0.93-1.15)
Obesity	1.02 (0.92-1.12)