Department of Medicine 1, Frankfurt University Hospital, Frankfurt am Main; WIdO - AOK Research Institute, Berlin; Department of General and Visceral Surgery, Frankfurt University Hospital, Frankfurt am Main.
Dtsch Arztebl Int. 2020 Jan 24;117(4):43-50. doi: 10.3238/arztebl.2020.0043.
Acute liver failure (ALF) is a life-threatening event associated with high mortality. Currently, only estimates are available for its incidence. The aim of the study was to assess the incidence of ALF in Germany, using the accounting data of the largest statutory health insurance company, which represents 26.5 million people.
The analysis included patients insured from 1 January 2014 to 31 December 2018. Coding with the International Statistical Classification of Diseases and Related Health Problems and the German operation and procedure codes were used to identify the patients, whose age, sex, liver transplantations (LT), and fatal outcomes were then recorded and extrapolated to the total population. As a validity check, the extrapolated LT results were compared with the LT that were actually performed.
The calculated incidence of ALF was 1.13/100 000 person-years, representing 4652 cases. Women were more often affected (52% versus 48%, p < 0.001). The overall rate of mortality within 3 months was 47%. A total of 203 LT were recorded in 176 patients. Men received 41% of the LT, women 59% (p < 0.137). The 1-year overall mortality rate after LT was 20%. The 203 calculated transplantations corresponded to 228 actually performed transplantations.
The incidence of ALF was higher than previously estimated for Germany, with only a very low rate of LT despite high mortality. When extrapolating ny, it must be borne in mind that those insured by the company concerned do not represent a valid sample.
急性肝衰竭 (ALF) 是一种危及生命的事件，死亡率很高。目前，仅对其发病率进行了估计。本研究的目的是使用最大的法定健康保险公司的会计数据评估德国的 ALF 发病率，该公司代表 2650 万人。
分析包括 2014 年 1 月 1 日至 2018 年 12 月 31 日期间投保的患者。使用国际疾病分类和相关健康问题的统计分类和德国手术和程序代码对患者进行编码，记录其年龄、性别、肝移植 (LT) 和死亡结局，并外推至总人口。作为有效性检查，将外推的 LT 结果与实际进行的 LT 进行比较。
计算的 ALF 发病率为 1.13/100000 人年，代表 4652 例。女性更常受到影响 (52%比 48%，p < 0.001)。3 个月内的总死亡率为 47%。共记录了 176 名患者的 203 例 LT。男性接受了 41%的 LT，女性接受了 59% (p < 0.137)。LT 后 1 年的总死亡率为 20%。计算的 203 例移植与实际进行的 228 例移植相对应。
德国的 ALF 发病率高于此前估计，尽管死亡率很高，但 LT 率却非常低。在进行外推时，必须记住，有关公司承保的人并不代表有效的样本。
