Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;51(5):691-698.
doi: 10.1111/imj.14809.

Changing prevalence of aetiological factors and comorbidities among Australians hospitalised for cirrhosis

Patricia C Valery  1   2 , Steven McPhail  3 , Katherine A Stuart  4 , Gunter Hartel  1 , Paul J Clark  5 , James O'Beirne  6 , Richard Skoien  7 , Tony Rahman  8 , Chris Moser  9 , Elizabeth E Powell  2   4
Affiliations

Changing prevalence of aetiological factors and comorbidities among Australians hospitalised for cirrhosis

Patricia C Valery et al. Intern Med J. 2021 May.

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.

Keywords: aetiology; chronic liver disease; comorbidity; epidemiology.

PubMed Disclaimer

References

    1. Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol 2019; 70: 151-71.
    1. 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.
    1. Fuster D, Samet JH. Alcohol use in patients with chronic liver disease. N Engl J Med 2018; 379: 1251-61.
    1. 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.
    1. 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.

LinkOut - more resources