Dates of death were obtained from the Danish Civil Registration System, which is continuously updated with dates of birth, death, and emigration.22 Causes of death were ascertained from the Danish Cause of Death Registry, with review of registry data to determine whether deaths were from cirrhosis or other causes. Death from liver failure, variceal bleeding,

bacterial infection, or hepatocellular carcinoma counted as death from cirrhosis. Data linkage across data sources was made possible by the find more unique personal identifier issued to all Danish citizens at birth or immigration and used in all national databases and record systems. At the time of inclusion into the study cohort, patients with alcoholic cirrhosis were classified into five categories

according to the presence and type of cirrhosis complications: no complications; ascites alone; variceal bleeding alone; ascites and variceal bleeding; hepatic encephalopathy with or without ascites and variceal bleeding. Patients who developed complications during follow-up were PI3K inhibitor cancer reclassified into another category if appropriate. Based on our clinical experience and a previous Danish study,23 we assumed that a given complication carried the same prognosis whether it had been present at the time of cirrhosis diagnosis or developed later. Racecadotril In all analyses follow-up ended at death or at censoring at the end of follow-up, on 31 August 2006. Analyses were conducted separately for the five complication categories and were based on the Aalen-Johansen estimator of the probability of having died or being in a particular category of cirrhosis complications at a particular point in time during follow-up.24, 25 Ninety-five percent

confidence intervals were bootstrapped. We conducted three types of analyses which differed in the handling of complications during follow-up. In the first analysis complications were ignored, hence the Aalen-Johansen method was simplified to a Kaplan-Meier analysis yielding the cumulative mortality and the median survival time, i.e., the time to reach a cumulative mortality of 50%. In the second analysis complications were taken into account, but follow-up continued when they developed. On that basis we estimated the distribution of cirrhosis complication categories after 1 and 5 years of follow-up using the following categorization: alive without more complications; alive with more complications; dead without more complications; and dead with more complications. In the third analysis follow-up ended whenever complications developed, whereby the Aalen-Johansen method amounted to estimating the 1-and 5-year cumulative incidence (i.e., risk) of complications or death as competing events.