Service of Internal Medicine, Etablissements Hospitaliers du Nord Vaudois, Yverdon-les-Bains, Switzerland
Department of Medicine, University of Lausanne Faculty of Biology and Medicine, Lausanne, Switzerland.
BMJ Open. 2024 Aug 24;14(8):e081822. doi: 10.1136/bmjopen-2023-081822.
Liver cirrhosis is an increasing cause of morbidity and mortality worldwide with a heavy load on healthcare systems. We analysed the trends in hospitalisations for cirrhosis in Switzerland.
Cross-sectional study.
Large nationwide inpatient database, years between 1998 and 2020.
Hospitalisations for cirrhosis of adult patients were selected.
Hospitalisations with either a primary diagnosis of cirrhosis or a cirrhosis-related primary diagnosis with a mandatory presence of cirrhosis as a secondary diagnosis were considered following the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes. Trends in demographic and clinical characteristics, in-hospital mortality and length of stay were analysed. Causes and costs of cirrhosis-related hospitalisations were available from 2012 onwards.
Cirrhosis-related hospitalisations increased from 1631 in 1998 to 4052 in 2020. Of the patients, 68.7% were men. Alcohol-related liver disease was the leading cause, increasing from 44.1% (95% CI, 42.4% to 45.9%) in 2012 to 47.9% (95% CI, 46.4% to 49.5%) in 2020. Assessed by exclusion of other coded causes, non-alcoholic fatty liver disease was the second cause at 42.7% (95% CI, 41.2% to 44.3%) in 2020. Hepatitis C virus-related cirrhosis decreased from 12.3% (95% CI, 11.2% to 13.5%) in 2012 to 3.2% (95% CI, 2.7% to 3.8%) in 2020. Median length of stay decreased from 11 to 8 days. Hospitalisations with an intensive care unit stay increased from 9.8% (95% CI, 8.4% to 11.4%) to 15.6% (95% CI, 14.5% to 16.8%). In-hospital mortality decreased from 12.1% (95% CI, 10.5% to 13.8%) to 9.7% (95% CI, 8.8% to 10.7%). Total costs increased from 54.4 million US$ (51.4 million €) in 2012 to 92.6 million US$ (87.5 million €) in 2020.
Cirrhosis-related hospitalisations and related costs increased in Switzerland from 1998 to 2020 but in-hospital mortality decreased. Alcohol-related liver disease and non-alcoholic fatty liver disease were the most prevalent and preventable aetiologies of cirrhosis-related hospitalisations.
肝硬化是全球发病率和死亡率不断上升的一个原因，给医疗系统带来了沉重的负担。我们分析了瑞士肝硬化住院治疗的趋势。
横断面研究。
大型全国住院患者数据库，1998 年至 2020 年期间。
选择成年患者的肝硬化住院治疗。
根据国际疾病分类和相关健康问题第 10 次修订版的标准，将主要诊断为肝硬化或肝硬化相关的主要诊断并伴有强制性肝硬化次要诊断的住院治疗均视为肝硬化。分析人口统计学和临床特征、住院死亡率和住院时间的趋势。自 2012 年起，提供了肝硬化相关住院治疗的原因和费用。
1998 年至 2020 年，与肝硬化相关的住院治疗从 1631 例增加到 4052 例。患者中 68.7%为男性。酒精性肝病是主要病因，从 2012 年的 44.1%（95%可信区间，42.4%至 45.9%）增加到 2020 年的 47.9%（95%可信区间，46.4%至 49.5%）。经排除其他编码病因评估，非酒精性脂肪性肝病为 2020 年的第二大病因，占 42.7%（95%可信区间，41.2%至 44.3%）。丙型肝炎病毒相关肝硬化从 2012 年的 12.3%（95%可信区间，11.2%至 13.5%）下降至 2020 年的 3.2%（95%可信区间，2.7%至 3.8%）。住院时间中位数从 11 天降至 8 天。入住重症监护病房的住院治疗比例从 9.8%（95%可信区间，8.4%至 11.4%）增加到 15.6%（95%可信区间，14.5%至 16.8%）。住院死亡率从 12.1%（95%可信区间，10.5%至 13.8%）降至 9.7%（95%可信区间，8.8%至 10.7%）。总费用从 2012 年的 5440 万美元（5140 万欧元）增加到 2020 年的 9260 万美元（8750 万欧元）。
1998 年至 2020 年，瑞士与肝硬化相关的住院治疗和相关费用增加，但住院死亡率下降。酒精性肝病和非酒精性脂肪性肝病是肝硬化相关住院治疗最常见和可预防的病因。
