Manno Valerio, Gerussi Alessio, Carbone Marco, Minelli Giada, Taruscio Domenica, Conti Susanna, Invernizzi Pietro
Service of Statistics National Institute of Health Rome Italy.
Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery University of Milano-Bicocca Monza Italy.
Hepatol Commun. 2019 Jul 15;3(9):1250-1257. doi: 10.1002/hep4.1407. eCollection 2019 Sep.
Epidemiological studies on primary biliary cholangitis (PBC) have been based primarily on tertiary referral case series. We aimed to estimate the incidence and prevalence and describe comorbidities in hospitalized patients with PBC in Italy using a national hospital-based data source. Data were extracted from the National Hospital Discharge Database, which includes all Italian individuals discharged from any hospital in the country. All adults diagnosed with biliary cirrhosis (International Classification of Diseases, Ninth Revision, Clinical Modification, 571.6) as the primary or secondary diagnosis from 2011 to 2015 were included. To determine whether a comorbidity was either more or less frequent in PBC patients compared with the general hospitalized Italian population, the standardized hospitalization ratio (SHR) was calculated. A total of 5,533 incident cases were identified from 2011 to 2015, 3,790 of whom were females (68.5%; female to male [F:M] ratio, 2.2:1). Prevalent cases were 9,664, of whom 7,209 were females (74.6%; F:M ratio, 2.9:1). The incident rate was 1.03 × 100,000 in males and 1.92 × 100,000 in females; prevalence was 1.89 × 100,000 in males and 4.75 × 100,000 in females. Extrahepatic autoimmune diseases, malignant neoplasms of liver and intrahepatic biliary ducts, and malignant neoplasms of gallbladder and extrahepatic bile ducts were found more frequently in PBC patients than in the general hospitalized population (SHR > 100), whereas cerebrovascular diseases and ischemic heart diseases were less frequent in PBC individuals (SHR < 100). This national study provides a survey of comorbidities associated with PBC. Hospitalized patients with PBC are more likely to have extrahepatic autoimmune diseases, hepatocellular carcinoma, and biliary tract cancers and a low risk of cardiovascular events.
原发性胆汁性胆管炎（PBC）的流行病学研究主要基于三级转诊病例系列。我们旨在利用全国性的医院数据源来估计意大利住院PBC患者的发病率和患病率，并描述其合并症情况。数据从国家医院出院数据库中提取，该数据库涵盖了在意大利任何医院出院的所有个体。纳入了2011年至2015年期间所有被诊断为原发性或继发性胆汁性肝硬化（国际疾病分类第九版临床修订本，571.6）的成年人。为了确定PBC患者的合并症与意大利普通住院人群相比是更常见还是更少见，计算了标准化住院率（SHR）。2011年至2015年共识别出5533例新发病例，其中3790例为女性（68.5%；女性与男性[F:M]比例为2.2:1）。现患病例为9664例，其中7209例为女性（74.6%；F:M比例为2.9:1）。男性发病率为1.03×10万，女性为1.92×10万；男性患病率为1.89×10万，女性为4.75×10万。与普通住院人群相比，PBC患者肝外自身免疫性疾病、肝脏和肝内胆管恶性肿瘤以及胆囊和肝外胆管恶性肿瘤更为常见（SHR>100），而PBC患者脑血管疾病和缺血性心脏病则较少见（SHR<100）。这项全国性研究对与PBC相关的合并症进行了调查。住院PBC患者更易患肝外自身免疫性疾病、肝细胞癌和胆道癌，心血管事件风险较低。
