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丹麦酒精性肝炎的发病率和死亡率——2016 - 2023年最新情况

Incidence and mortality of alcohol-related hepatitis in Denmark - an update, 2016-2023.

作者信息

Hazrat Khaibar Ghulam, Støy Sidsel Hyldgaard, Sandahl Thomas Damgaard, Jepsen Peter

机构信息

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.

出版信息

JHEP Rep. 2025 Mar 12;7(6):101390. doi: 10.1016/j.jhepr.2025.101390. eCollection 2025 Jun.

Abstract

BACKGROUND & AIMS: Alcohol-related hepatitis (AH) is a severe liver disease associated with high mortality. This study provides data on the incidence and mortality of AH in Denmark from 2016 to 2023.

METHODS

We identified all patients with a first-time hospital discharge diagnosis of AH and a serum bilirubin level >3 mg/dl in 2016-2023. We computed the standardized incidence rate of AH in the Danish population and mortality from admission with AH. We compared the results to our previously published findings for the 1999-2008 period.

RESULTS

We included 1,016 patients with a median age of 54.7 years (66% men). The standardized incidence rate was 21.7 per million per year, which remained stable during the study period for both men and women. Mortality was high: 18% at 28 days, 26% at 84 days, and 40% at 365 days. Although 28-day and 84-day mortality risks were lower in 2023 compared to earlier years, no overall trend of improvement was observed. The median MELD score at admission, available for 846 patients, was consistently high at 26, and 75% had severe AH (MELD >21). Compared to an incidence rate of approximately 45 per million per year in 2009, the incidence of AH has since decreased dramatically, mirroring Danish alcohol sales.

CONCLUSIONS

The incidence of AH in Denmark markedly declined from 2009 but stabilized between 2016 and 2023. Mortality remains high, emphasizing the need for better treatment strategies.

IMPACT AND IMPLICATIONS

This study investigated the incidence and mortality of alcohol-related hepatitis (AH) in Denmark from 2016 to 2023, providing updated data in the context of declining alcohol consumption. While AH incidence has decreased since 2009, mirroring reduced alcohol intake, it has stabilized in recent years, and mortality remains high. These findings highlight the ongoing burden of AH for healthcare providers, researchers, and policymakers. Our results can support early interventional strategies, guide clinical management, and reinforce public health efforts to reduce alcohol consumption. Limitations, such as the lack of detailed treatment data, should be considered to avoid overgeneralization.

摘要

背景与目的

酒精性肝炎(AH)是一种严重的肝脏疾病,死亡率很高。本研究提供了2016年至2023年丹麦AH的发病率和死亡率数据。

方法

我们确定了2016 - 2023年所有首次因AH出院诊断且血清胆红素水平>3mg/dl的患者。我们计算了丹麦人群中AH的标准化发病率以及AH入院后的死亡率。我们将结果与我们之前发表的1999 - 2008年期间的研究结果进行了比较。

结果

我们纳入了1016例患者,中位年龄为54.7岁(66%为男性)。标准化发病率为每年每百万21.7例,在研究期间男性和女性均保持稳定。死亡率很高:28天时为18%,84天时为26%,365天时为40%。尽管2023年28天和84天的死亡风险低于早年,但未观察到总体改善趋势。846例患者入院时的中位终末期肝病模型(MELD)评分持续较高,为26分,75%患有严重AH(MELD>21)。与2009年每年约每百万45例的发病率相比,此后AH的发病率大幅下降,与丹麦的酒精销售量情况相符。

结论

丹麦AH的发病率自2009年以来显著下降,但在2016年至2023年期间趋于稳定。死亡率仍然很高,这凸显了需要更好的治疗策略。

影响与意义

本研究调查了2016年至2023年丹麦酒精性肝炎(AH)的发病率和死亡率,在酒精消费下降的背景下提供了最新数据。自2009年以来,AH发病率下降,反映了酒精摄入量减少,但近年来已趋于稳定,且死亡率仍然很高。这些发现凸显了AH对医疗服务提供者、研究人员和政策制定者持续存在的负担。我们的结果可以支持早期干预策略,指导临床管理,并加强减少酒精消费的公共卫生努力。应考虑到局限性,如缺乏详细的治疗数据,以避免过度概括。

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