Common Digestive and Liver Diseases among 5880 Patients Admitted to Shariati Hospital,Tehran,Iran during 2000-2009

Abstract

BACKGROUND Digestive and liver diseases (LD) are among the most common causes of mortality and morbidity in Iran and throughout the world. We have aimed to report the etiology and outcome of gastrointestinal and LD that needed admission in a typical tertiary referral hospital in Tehran during the last decade. METHODS Shariati Hospital Gastroenterology and Liver Disease Department (GI & LD) was established in 1974. Information on admitted patients in this department, such as age, gender, clinical, laboratory and imaging results, fi nal diagnosis (according to ICD-10), and hospital outcome have been regularly collected by a special summary form since 1999. For this study, the results were analyzed and compared for two, 5-year time periods, 2000-2004 and 2005-2009. RESULTS There were 5880 patients (64.60% male) with a mean age of 51.8 years (range: 12 to 90 years) who were admitted. The hospital mortalityrate was 6.80%, of which 71.53% were male. The most common cause of hospital admission (39.25%) and mortality (38.55%) was chronic LD. The most common etiologies for admission in both genders were HBV and cryptogenic or non-alcoholic fatty LD(NAFLD) induced cirrhosis of the liver. Other common etiologies were gastrointestinal bleeding, HCV-induced cirrhosis, and CBD stones in male patients;CBD stones, gastrointestinal bleeding and autoimmune hepatitis in female patients. The rate of admission due to HBV-related LD decreased from 21.73% to 11.15%, while admission due to NAFLD-related liver (cryptogenic) disease remained unchanged (11.60% to 10.49%). The rate of admission for pancreatic cancer increased from 1.71% to 4.56%, CBD stones from 6.96% to 10.22%, cholangitis from 3.37% to 6.93%, acute pancreatitis from 2.54% to 4.65%, and Crohn's disease from 1.93% to 2.72%. CONCLUSION End-stage LD secondary to viral, autoimmune and NAFLD constitute the etiology of up to 50% of admissions and mortalities in Shariati Hospital for both genders. While the admission rate of HBV-related LD is declining, the rate of NAFLD-related LD remains stable. The rates of admission for pancreatic cancer, CBD stone, cholangitis, acute pancreatitis and crohn disease increased over the decade.

Keywords: Digestive disease; Hospital admission rate; Iran; Outcome.