Abstract
BACKGROUND: Cirrhosis is rare in young individuals, and clinical differences between young and adult patients remain unclear. This study aimed to evaluate the clinical characteristics and prognosis of HBV-related cirrhosis in young patients. METHODS: A hospital-based retrospective cohort of young cirrhosis patients was analyzed. Multivariable analysis identified risk factors for severe complications during follow-up, while the Cox proportional-hazards model assessed the prognosis of young and adult patients with HBV-related cirrhosis. Prognosis was assessed after baseline covariates were balanced using propensity score matching (PSM). RESULTS: The study included 545 patients with cirrhosis, including 119 in the younger group. Young patients with HBV-related cirrhosis exhibited significant differences from adult patients in gender, Alb, ALT, AST, and HBV titer. Kaplan-Meier analysis indicated a higher survival rate in the young group (P = 0.04); however, no significant difference remained after PSM. Youth was identified as an independent risk factor for gastrointestinal bleeding during follow-up (OR = 3.61, 95% CI: 1.62-8.00, P = 0.002). Additionally, age and elevated ALP levels were independent risk factors for survival. The Cox-based prediction model showed moderate prognostic performance, with a C-index of 0.69. CONCLUSION: After baseline differences were balanced, young patients with HBV-related cirrhosis showed no survival advantage. Vigilant monitoring for serious complications, particularly gastrointestinal bleeding, is warranted. These findings may inform targeted interventions to reduce the burden of early onset cirrhosis.