摘要：In recent years, multistate mo dels have been studied widely in survival analysis. This article illustrates the use of multistate Markov mo del to estimate the incubation period of cirrhosis and HCC from prevalent cohorts and to evaluate the e.ect of various prog- nostic factors on the disease progression. This kind of study is being done for the first time on Indian population wherein a retrospective data of 824 admitted patients su.er- ing from liver cirrhosis and HCC has been obtained and analyzed to evaluate the e.ect of covariates on the transition/survival of these patients. It is observed that presence of encephalopathy, LGI bleed, altered sensorium, older age and raised level of serum creatinine are the significant contributors for the death of patients due to liver disease who were initially diagnosed with liver cirrhosis. Also, presence of black stools and high creatinine levels plays an important role in transition from cirrhosis to HCC. Patients initially in HCC state with the presenting symptoms of ascites, LGI bleed and altered sensorium faces higher probability of death due to liver disease. Hence, it can be conclu- sively established that presence of ascites, encephalopathy and LGI bleed play a major role for liver disease patient in bridging a path to mortality.
关键词：Multistate Markov model ; Cirrhosis ; HCC ; Disease progression
