Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Intern Med J. 2021 May;51(5):691-698. doi: 10.1111/imj.14809.
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.
To examine the temporal change in aetiology of liver disease and presence of comorbidity in patients admitted with cirrhosis.
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.
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.
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.
2008 年至 2016 年期间，昆士兰州因肝硬化住院的人数增加了 1.3 倍。酒精滥用是导致 55%肝硬化患者入院的一个因素，40%的患者至少有一种合并症。
研究肝硬化患者入院时病因和合并症的时间变化。
这是一项基于人群的回顾性队列研究，对 2008 年至 2016 年期间在昆士兰州因肝硬化住院治疗的所有人（10254 名患者）进行研究。数据来源于昆士兰医院住院患者数据采集。
最常见的病因是酒精（49.5%），其次是不明原因（未特指的肝硬化；28.5%）、丙型肝炎病毒（19.3%）、非酒精性脂肪性肝病（NAFLD）/非酒精性脂肪性肝炎（NASH）（4.8%）和乙型肝炎病毒（HBV）（4.3%）。2008-2010 年和 2014-2016 年之间，酒精相关（P = 0.41）和丙型肝炎病毒（P = 0.08）的患病率保持稳定，而 NASH、不明原因和 HBV 肝硬化的患病率分别增加了 67%（P < 0.00001）、27%（P < 0.00001）和 20%（P = 0.00019）；41.1%的患者至少有一种合并症。2008-2010 年和 2014-2016 年之间，2 型糖尿病的患病率几乎翻了一番（从 13.7%增加到 25.4%；P < 0.00001）。
酒精滥用是最重要的病因。2008-2016 年期间，NAFLD/NASH、不明原因和 HBV 肝硬化的重要性以及合并症的负担增加。肝硬化患者中持续的酒精滥用以及 NAFLD/NASH、不明原因肝硬化和合并 2 型糖尿病的患病率增加，对减少不健康生活方式和代谢紊乱负担的公共卫生干预措施具有重要意义。
