{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:15Z","timestamp":1787017935235,"version":"build-2736575974"},"reference-count":25,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Dis"],"published-print":{"date-parts":[[2021]]},"abstract":"<b><i>Background and Goals:<\/i><\/b> The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis. <b><i>Methods:<\/i><\/b> Between January 2001 and January 2018, a total of 1,341 patients had been diagnosed with cirrhosis and were included. <b><i>Results:<\/i><\/b> A total of 898 cirrhotic patients, who were followed up for at least 6 months were included into the analysis. The median age was 54 years. The median Child-Pugh and MELD scores were 7.5 and 11, respectively. Ascites (51%) was the most common causes of decompensation. Chronic viral hepatitis was the most frequent cause of cirrhosis (58%). Hepatitis B virus (HBV) infection was the main etiology (34%), followed by hepatitis C virus (HCV) infection (18%). Among 129 patients with cryptogenic cirrhosis (CC), 60 had metabolic abnormalities. If these 60 patients with CC were considered to have nonalcoholic fatty liver disease (NAFLD)-related cirrhosis, the proportion of NAFLD-related cirrhosis increased from 1.8 to 8.0%. At admission, 74 patients (8%) had been diagnosed with hepatocellular carcinoma (HCC). A new HCC developed in 80 patients during the follow-up period. The probability of developing HCC was 3.9% at 12 months. Logistic regression analysis showed that the development of HCC was significantly associated with older age (<i>p<\/i> &#x3c; 0.001), male gender (<i>p<\/i> &#x3c; 0.001), viral etiology (<i>p<\/i> = 0.026), and baseline high aspartate aminotransferase level (<i>p<\/i> = 0.01). Overall, 104 cirrhotic patients died. <b><i>Conclusion:<\/i><\/b> HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. 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