Changing prevalence of aetiological factors and comorbidities among Australians hospitalised for cirrhosis.
aetiology
chronic liver disease
comorbidity
epidemiology
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
10
02
2020
received:
04
11
2019
accepted:
17
02
2020
pubmed:
26
2
2020
medline:
12
6
2021
entrez:
26
2
2020
Statut:
ppublish
Résumé
The rate of hospital admissions for cirrhosis increased 1.3-fold during 2008-2016 in Queensland. Alcohol misuse was a contributing factor for cirrhosis in 55% of admissions and 40% of patients had at least one comorbidity. To examine the temporal change in aetiology of liver disease and presence of comorbidity in patients admitted with cirrhosis. Population-based retrospective cohort study of all people treated in hospital for cirrhosis (10 254 patients) in Queensland during 2008-2016. Data were sourced from Queensland Hospital Admitted Patient Data Collection. The commonest aetiology was alcohol (49.5%), followed by cryptogenic (unspecified cirrhosis; 28.5%), hepatitis C virus (19.3%), non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) (4.8%) and hepatitis B virus (HBV) (4.3%). The prevalence of alcohol-related (P = 0.41) and hepatitis C virus (P = 0.08) remained stable between 2008-2010 and 2014-2016, that of NAFLD/NASH, cryptogenic and HBV-cirrhosis increased by 67% (P < 0.00001), 27% (P < 0.00001) and 20% (P = 0.00019), respectively; 41.1% of patients had at least one comorbidity. The prevalence of type 2 diabetes nearly doubled (from 13.7% to 25.4%; P < 0.00001) between 2008-2010 and 2014-2016. Alcohol misuse was the most important aetiology. The importance of NAFLD/NASH, cryptogenic and HBV-cirrhosis and the burden of comorbidity increased during 2008-2016. Ongoing alcohol misuse and the increasing prevalence of NAFLD/NASH, cryptogenic cirrhosis and comorbid type 2 diabetes among admissions for cirrhosis has implications for public health interventions to reduce the burden of unhealthy lifestyle and metabolic disorders.
Sections du résumé
BACKGROUND
BACKGROUND
The rate of hospital admissions for cirrhosis increased 1.3-fold during 2008-2016 in Queensland. Alcohol misuse was a contributing factor for cirrhosis in 55% of admissions and 40% of patients had at least one comorbidity.
AIMS
OBJECTIVE
To examine the temporal change in aetiology of liver disease and presence of comorbidity in patients admitted with cirrhosis.
METHODS
METHODS
Population-based retrospective cohort study of all people treated in hospital for cirrhosis (10 254 patients) in Queensland during 2008-2016. Data were sourced from Queensland Hospital Admitted Patient Data Collection.
RESULTS
RESULTS
The commonest aetiology was alcohol (49.5%), followed by cryptogenic (unspecified cirrhosis; 28.5%), hepatitis C virus (19.3%), non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) (4.8%) and hepatitis B virus (HBV) (4.3%). The prevalence of alcohol-related (P = 0.41) and hepatitis C virus (P = 0.08) remained stable between 2008-2010 and 2014-2016, that of NAFLD/NASH, cryptogenic and HBV-cirrhosis increased by 67% (P < 0.00001), 27% (P < 0.00001) and 20% (P = 0.00019), respectively; 41.1% of patients had at least one comorbidity. The prevalence of type 2 diabetes nearly doubled (from 13.7% to 25.4%; P < 0.00001) between 2008-2010 and 2014-2016.
CONCLUSIONS
CONCLUSIONS
Alcohol misuse was the most important aetiology. The importance of NAFLD/NASH, cryptogenic and HBV-cirrhosis and the burden of comorbidity increased during 2008-2016. Ongoing alcohol misuse and the increasing prevalence of NAFLD/NASH, cryptogenic cirrhosis and comorbid type 2 diabetes among admissions for cirrhosis has implications for public health interventions to reduce the burden of unhealthy lifestyle and metabolic disorders.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
691-698Subventions
Organisme : Brisbane Diamantina Health Partners
Organisme : National Health and Medical Research Council
ID : 1083090
Organisme : National Health and Medical Research Council
ID : 1090440
Informations de copyright
© 2020 Royal Australasian College of Physicians.
Références
Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol 2019; 70: 151-71.
Powell EE, Skoien R, Rahman T, Clark PJ, O'Beirne J, Hartel G et al. Increasing hospitalization rates for cirrhosis: overrepresentation of disadvantaged Australians. EClinicalMedicine 2019; 11: 44-53.
Fuster D, Samet JH. Alcohol use in patients with chronic liver disease. N Engl J Med 2018; 379: 1251-61.
Rinaldi L, Nascimbeni F, Giordano M, Masetti C, Guerrera B, Amelia A et al. Clinical features and natural history of cryptogenic cirrhosis compared to hepatitis C virus-related cirrhosis. World J Gastroenterol 2017; 23: 1458-68.
Caldwell SH, Oelsner DH, Iezzoni JC, Hespenheide EE, Battle EH, Driscoll CJ. Cryptogenic cirrhosis: clinical characterization and risk factors for underlying disease. Hepatology 1999; 29: 664-9.
McCall C. Australia commits funds to curb hepatitis C epidemic. Lancet 2016; 387: 419.
Collaborators GBDO, Afshin A, Forouzanfar MH et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017; 377: 13-27.
World Health Organization. Global Status Report on Alcohol and Health. Geneva: WHO; 2018; 2018.
Sharma S, Carballo M, Feld JJ, Janssen HL. Immigration and viral hepatitis. J Hepatol 2015; 63: 515-22.
Australian Bureau of Statistics. Migration Australia, 2016-17. Canberra: ABS; 2018.
Ratib S, Fleming KM, Crooks CJ, Aithal GP, West J. 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998-2009: a large population study. J Hepatol 2014; 60: 282-9.
Jepsen P, Vilstrup H, Andersen PK, Lash TL, Sorensen HT. Comorbidity and survival of Danish cirrhosis patients: a nationwide population-based cohort study. Hepatology 2008; 48: 214-20.
Goh GB, Pan A, Chow WC, Yuan JM, Koh WP. Association between diabetes mellitus and cirrhosis mortality: the Singapore Chinese health study. Liver Int 2017; 37: 251-8.
Yki-Jarvinen H, Luukkonen PK. Diabetes, liver cancer, and cirrhosis: what next? Hepatology 2018; 68: 1220-2.
Nanditha A, Ma RC, Ramachandran A et al. Diabetes in Asia and the Pacific: implications for the global epidemic. Diabetes Care 2016; 39: 472-85.
Australian Institute of Health and Welfare. Rural, Regional and Remote Health: A Guide to Remoteness Classifications. Canberra: AIHW; 2004.
Australian Bureau of Statistics. Census of Population and Housing: Socio-economic Indexes for Areas (SEIFA), Australia. Canberra: ABS; 2006; 2008.
Powell EE, Cooksley WG, Hanson R, Searle J, Halliday JW, Powell LW. The natural history of nonalcoholic steatohepatitis: a follow-up study of forty-two patients for up to 21 years. Hepatology 1990; 11: 74-80.
Younossi Z, Stepanova M, Sanyal AJ, Harrison SA, Ratziu V, Abdelmalek MF et al. The conundrum of cryptogenic cirrhosis: adverse outcomes without treatment options. J Hepatol 2018; 69: 1365-70.
Commonwealth of Australia (Department of Health). National Alcohol Strategy 2018-2026. Canberra: Commonwealth of Australia (Department of Health); 2017.
Australian Institute of Health and Welfare. Australia's Health 2018. Canberra: AIHW; 2018.
d'Emden MC, Shaw JE, Colman PG, Colagiuri S, Twigg SM, Jones GR et al. The role of HbA1c in the diagnosis of diabetes mellitus in Australia. Med J Aust 2012; 197: 220-1.
Australian Bureau of Statistics. National Health Survey, 2017-2018. Canberra: ABS; 2018.
Queensland Health. Queensland Hospital Admitted Patient Data Collection (QHAPDC) Manual 2015-2016 Collection Year. Brisbane: State of Queensland (Queensland Health); 2015.
Mapakshi S, Kramer JR, Richardson P, El-Serag HB, Kanwal F. Positive predictive value of international classification of diseases, 10th revision, codes for cirrhosis and its related complications. Clin Gastroenterol Hepatol 2018; 16: 1677-8.
Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005; 43: 1130-9.
Perneger TV. What's wrong with Bonferroni adjustments. BMJ 1998; 316: 1236-8.