Perspectives on Cirrhosis in Southern Iran: A Temporal Comparative Study from 2009 to 2016

Background: The epidemiology of cirrhosis, a significant public health issue, remains poorly understood in Iran. Objectives: This study aimed to evaluate the characteristics, etiologies, complications, and outcomes of patients with cirrhosis who were registered in the Shiraz cirrhosis registry in Iran. Methods: In this descriptive-analytical study, a total of 2937 patients with cirrhosis from 2009 to 2016, and 683 patients from 2017 to 2022 were enrolled at Shahid Motahhari clinic in Shiraz and included in our database. Demographic, clinical, and laboratory data were collected at baseline and every six months thereafter. Mortality, hepatocellular carcinoma, and liver transplantation occurrences were monitored biannually. Statistical differences between groups were assessed using the Mann-Whitney U test, chi-square test, or Fisher's exact test, depending on the data distribution and the nature of the variables. Results: The average age of patients during the first period was 47.4 ± 21.5 years, and for the second period, it was 54.8 ± 14.1 years. Biochemical levels and the prevalence of most complications were higher in the second period compared to the first. Ascites was the most common complication in the first group (52.1%), while esophageal varices were more prevalent in the second (40.1%). Hepatitis B and C were common among patients, especially in men. Patients registered in the earlier period had higher mortality and liver transplantation rates than those in the later period. Conclusions: The findings suggest that patients registered in the later period displayed better laboratory and clinical outcomes, likely due to improved management strategies over time. Viral hepatitis B and C were identified as the predominant etiologies among the patients with cirrhosis included in the study.