Patricia C Valery1,2, Steven McPhail3, Katherine A Stuart4, Gunter Hartel1, Paul J Clark5, James O'Beirne6, Richard Skoien7, Tony Rahman8, Chris Moser9, Elizabeth E Powell2,4. 1. Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 2. Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia. 3. Centre for Functioning and Health Research, Queensland Health and the School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. 4. Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia. 5. Department of Gastroenterology and Hepatology, Mater Hospitals, Brisbane, Queensland, Australia. 6. Department of Gastroenterology and Hepatology, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia. 7. Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 8. Gastroenterology and Hepatology Department, The Prince Charles Hospital, Brisbane, Queensland, Australia. 9. Statistical Services Branch, Queensland Health, Brisbane, Queensland, Australia.
Abstract
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: To examine the temporal change in aetiology of liver disease and presence of comorbidity in patients admitted with cirrhosis. 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: 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: 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.
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: To examine the temporal change in aetiology of liver disease and presence of comorbidity in patients admitted with cirrhosis. 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: The commonest aetiology was alcohol (49.5%), followed by cryptogenic (unspecifiedcirrhosis; 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: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.
Authors: Patricia C Valery; Christina M Bernardes; Kelly L Hayward; Gunter Hartel; Katelin Haynes; Louisa G Gordon; Katherine A Stuart; Penny L Wright; Amy Johnson; Elizabeth E Powell Journal: BMC Gastroenterol Date: 2022-07-14 Impact factor: 2.847
Authors: Patricia C Valery; Elizabeth E Powell; Kelly Lee Hayward; Amy L Johnson; Leigh U Horsfall; Chris Moser Journal: BMJ Open Gastroenterol Date: 2021-02
Authors: Natalie Ly Ngu; Edward Saxby; Thomas Worland; Patricia Anderson; Lisa Stothers; Anita Figredo; Jo Hunter; Alexander Elford; Phil Ha; Imogen Hartley; Andrew Roberts; Dean Seah; George Tambakis; Danny Liew; Benjamin Rogers; William Sievert; Sally Bell; Suong Le Journal: Trials Date: 2022-09-05 Impact factor: 2.728
Authors: Elizabeth E Powell; Patricia C Valery; Amy L Johnson; Isanka U Ratnasekera; Katharine M Irvine; Andrew Henderson Journal: BMJ Open Gastroenterol Date: 2021-12