Sieloff Eric M, Rutledge Brian, Huffman Cuyler, Vos Duncan, Melgar Thomas
Department of Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.
Department of Internal Medicine, Division of Gastroenterology, Wayne State University School of Medicine, Detroit, MI, USA.
Gastroenterol Rep (Oxf). 2021 Jan 15;9(1):38-48. doi: 10.1093/gastro/goaa091. eCollection 2021 Jan.
Medical literature on the prevalence of genetic liver disease is lacking. In this study, we investigated the in-hospital healthcare and economic burden from genetic causes of non-alcoholic chronic liver disease (NACLD) and non-alcoholic liver cirrhosis (NALC) in the USA.
Data were abstracted from the National Inpatient Sample database between 2002 and 2014 using ICD9 codes for patients discharged with NACLD and NALC secondary to genetic diseases including alpha-1 antitrypsin deficiency (A1ATd), cystic fibrosis (CF), Wilson disease (WD), hereditary hemochromatosis (HHC), glycogen storage disease, and disorders of aromatic amino-acid metabolism (DAAAM).
Throughout the study period, there were 19,332 discharges for NACLD associated with the six genetic diseases including 14,368 for NALC. There were $1.09 billion in hospital charges, 790 in-hospital deaths, and 955 liver transplants performed. Overall, A1ATd was associated with 8,983 (62.52%) hospitalizations for NALC followed by WD, CF, and HHC. The highest in-hospital mortality was seen with HHC. The greatest frequency of liver transplants was seen with DAAAM.
The number of hospitalizations for genetic liver diseases continues to increase. With increased funding and directed research efforts, we can aim to improve medical treatments and the quality of life for patients at risk for liver deterioration.
关于遗传性肝病患病率的医学文献匮乏。在本研究中,我们调查了美国非酒精性慢性肝病(NACLD)和非酒精性肝硬化(NALC)的遗传病因所导致的住院医疗和经济负担。
使用国际疾病分类第九版(ICD9)编码,从2002年至2014年的全国住院患者样本数据库中提取数据,这些患者因遗传性疾病继发NACLD和NALC而出院,这些遗传性疾病包括α-1抗胰蛋白酶缺乏症(A1ATd)、囊性纤维化(CF)、威尔逊病(WD)、遗传性血色素沉着症(HHC)、糖原贮积病以及芳香族氨基酸代谢紊乱(DAAAM)。
在整个研究期间,有19332例与六种遗传疾病相关的NACLD出院病例,其中包括14368例NALC出院病例。住院费用达10.9亿美元,住院死亡790例,进行了955例肝移植。总体而言,A1ATd与8983例(62.52%)NALC住院病例相关,其次是WD、CF和HHC。HHC的住院死亡率最高。DAAAM的肝移植频率最高。
遗传性肝病的住院病例数持续增加。通过增加资金投入和有针对性的研究工作,我们旨在改善对有肝脏恶化风险患者的医疗治疗和生活质量。