Long-term Liver-related Outcomes of Patients With Chronic Liver Diseases in Australia.

Carcinoma, Hepatocellular / epidemiology Hepatitis C, Chronic / complications Humans Liver Cirrhosis Liver Neoplasms / epidemiology Liver Transplantation
ALD Cirrhosis HCC Survival

Journal

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775

Informations de publication

Date de publication:
02 2020
Historique:
received: 09 07 2018
revised: 04 07 2019
accepted: 09 07 2019
pubmed: 19 7 2019
medline: 19 8 2021
entrez: 19 7 2019
Statut: ppublish

Résumé

Chronic liver disease is a major health burden that produces significant liver-related morbidity and mortality. We aimed to evaluate liver-related outcomes of patients with different causes of chronic liver disease in Australia. We collected data from 10,933 patients with chronic liver disease assessed by Hepascore (a serum fibrosis model) in Western Australia from 2004 through 2015. We obtained records of liver-related death, transplantation, decompensation, and hepatocellular carcinoma from WA Data Linkage Unit databases. Competing risk analysis was used to calculate the cumulative risk of each clinical endpoint, and risks for clinical endpoints were compared among all causes of chronic liver disease. In our final cohort for analysis, 5566 patients had hepatitis C virus (HCV) infection, 1989 had HBV infection, 119 were infected with HBV and HCV, 955 had alcohol-associated liver disease, 1597 had non-alcoholic fatty liver disease (NAFLD), 123 had alcohol-associated liver disease and metabolic risk factors, 561 had autoimmune liver disease without overlap syndrome, and 23 autoimmune overlap syndrome. Significant differences among chronic liver diseases were observed in risk of all-cause death (P < .001), liver-related death (P < .001), liver transplantation (P < .001), and decompensation (P < .001) but not hepatocellular carcinoma (P=.095). Patients with alcohol-associated liver disease had the highest 5-year cumulative risk of liver-related death (17.1%) and the second-highest 5-year cumulative risk of decompensation (29.2%). Multivariate analysis found patients with alcohol-associated liver disease had significantly higher risks of liver-related death and decompensation than patients with HCV infection with hazard ratios (HRs) of 2.39 (95% CI, 1.88-3.03) and 3.42 (95% CI, 2.74-4.27), respectively. Patients with NAFLD had a significantly lower risk of liver related death and decompensation than patients with HCV infection, with HRs of 0.67 (95% CI, 0.48-0.95) and 0.70 (95% CI, 0.52-0.94) respectively. In an analysis of patients in Western Australia, we found patients with alcohol-associated liver disease to have significantly higher risk of decompensation and liver-related death than patients with HCV infection, whereas patients with NAFLD have significantly lower risks of either outcome.

Sections du résumé

BACKGROUND & AIMS
Chronic liver disease is a major health burden that produces significant liver-related morbidity and mortality. We aimed to evaluate liver-related outcomes of patients with different causes of chronic liver disease in Australia.
METHODS
We collected data from 10,933 patients with chronic liver disease assessed by Hepascore (a serum fibrosis model) in Western Australia from 2004 through 2015. We obtained records of liver-related death, transplantation, decompensation, and hepatocellular carcinoma from WA Data Linkage Unit databases. Competing risk analysis was used to calculate the cumulative risk of each clinical endpoint, and risks for clinical endpoints were compared among all causes of chronic liver disease.
RESULTS
In our final cohort for analysis, 5566 patients had hepatitis C virus (HCV) infection, 1989 had HBV infection, 119 were infected with HBV and HCV, 955 had alcohol-associated liver disease, 1597 had non-alcoholic fatty liver disease (NAFLD), 123 had alcohol-associated liver disease and metabolic risk factors, 561 had autoimmune liver disease without overlap syndrome, and 23 autoimmune overlap syndrome. Significant differences among chronic liver diseases were observed in risk of all-cause death (P < .001), liver-related death (P < .001), liver transplantation (P < .001), and decompensation (P < .001) but not hepatocellular carcinoma (P=.095). Patients with alcohol-associated liver disease had the highest 5-year cumulative risk of liver-related death (17.1%) and the second-highest 5-year cumulative risk of decompensation (29.2%). Multivariate analysis found patients with alcohol-associated liver disease had significantly higher risks of liver-related death and decompensation than patients with HCV infection with hazard ratios (HRs) of 2.39 (95% CI, 1.88-3.03) and 3.42 (95% CI, 2.74-4.27), respectively. Patients with NAFLD had a significantly lower risk of liver related death and decompensation than patients with HCV infection, with HRs of 0.67 (95% CI, 0.48-0.95) and 0.70 (95% CI, 0.52-0.94) respectively.
CONCLUSIONS
In an analysis of patients in Western Australia, we found patients with alcohol-associated liver disease to have significantly higher risk of decompensation and liver-related death than patients with HCV infection, whereas patients with NAFLD have significantly lower risks of either outcome.

Identifiants

DOI: 10.1016/j.cgh.2019.07.013 PMID: 31319186
pubmed: 31319186
pii: S1542-3565(19)30746-3
doi: 10.1016/j.cgh.2019.07.013
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

496-504.e3

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Auteurs

Yi Huang (Y)

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia.

John Joseph (J)

Department of Biochemistry, PathWest Laboratory Medicine, Perth, Australia.

W Bastiaan de Boer (WB)

Department of Anatomical Pathology, PathWest Laboratory Medicine, Perth, Australia.

Wendy Cheng (W)

Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, Australia.

Leon A Adams (LA)

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia.

Gerry MacQuillan (G)

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia.

George Garas (G)

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia.

Spiro Raftopoulos (S)

Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia.

Gary P Jeffrey (GP)

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia. Electronic address: gary.jeffrey@uwa.edu.au.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Carcinome hépatocellulaire › Long-term Liver-related Outcomes of Patients...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › Hépatite chronique › Hépatite C chronique › Long-term Liver-related Outcomes of Patients...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Long-term Liver-related Outcomes of Patients...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Fibrose › Cirrhose du foie › Long-term Liver-related Outcomes of Patients...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Long-term Liver-related Outcomes of Patients...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation de tissu › Transplantation hépatique › Long-term Liver-related Outcomes of Patients...