Carrier P, Debette-Gratien M, Jacques J, Loustaud-Ratti V. Cirrhotic patients and older people. World J Hepatol 2019; 11(9): 663-677 [PMID: 31598192 DOI: 10.4254/wjh.v11.i9.663]
Corresponding Author of This Article
Véronique Loustaud-Ratti, MD, Professor, Fédération d’Hépatologie, Centre Hospitalier Universitaire Dupuytren de Limoges, 2 Avenue Martin Luther King, Limoges 87042, France. veronique.loustaud-ratti@unilim.fr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2019; 11(9): 663-677 Published online Sep 27, 2019. doi: 10.4254/wjh.v11.i9.663
Cirrhotic patients and older people
Paul Carrier, Marilyne Debette-Gratien, Jérémie Jacques, Véronique Loustaud-Ratti
Paul Carrier, Marilyne Debette-Gratien, Véronique Loustaud-Ratti, Fédération d’Hépatologie, Centre Hospitalier Universitaire Dupuytren de Limoges, Limoges 87042, France
Paul Carrier, Marilyne Debette-Gratien, Véronique Loustaud-Ratti, Faculté de Médecine et de Pharmacie de Limoges, Rue Docteur Marcland, Limoges 87042, France
Jérémie Jacques, Service de Gastroentérologie, Centre Hospitalier Universitaire Dupuytren de Limoges, Limoges 87042, France
Author contributions: Carrier P wrote the manuscript and oversaw editorial consistency; Debette-Gratien M and Jacques J reread the manuscript and assisted in the constitution of the bibliography; Loustaud-Ratti V reread the manuscript and oversaw editorial consistency.
Conflict-of-interest statement: The author declares no potential conflicts of interest in relation to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Véronique Loustaud-Ratti, MD, Professor, Fédération d’Hépatologie, Centre Hospitalier Universitaire Dupuytren de Limoges, 2 Avenue Martin Luther King, Limoges 87042, France. veronique.loustaud-ratti@unilim.fr
Telephone: +33-5-5556684
Received: April 17, 2019 Peer-review started: April 17, 2019 First decision: June 3, 2019 Revised: June 18, 2019 Accepted: July 16, 2019 Article in press: July 17, 2019 Published online: September 27, 2019
Core Tip
Core tip: Few large studies have addressed the needs of older cirrhotic patients. The concept of healthy ageing is increasingly important. Cirrhosis is underdiagnosed in older patients, and comorbidities, comedications, and frailty impact the prognosis. The frequency of non-alcoholic fatty liver disease as an aetiology of cirrhosis is increasing, while that of viral hepatitis is decreasing, and the role of alcohol consumption is underestimated. The management of complications in older cirrhotic patients is similar to that in younger patients despite the higher risk of treatment-related adverse events. Therapeutic indications for a transjugular intrahepatic portosystemic shunt or admission to an intensive care unit should be carefully considered. Finally, older patients require tailored exercise and nutrition programs, and treatment of osteoporosis is crucial.
