• Internal medicine journal · May 2021

    Changing prevalence of aetiological factors and comorbidities among Australians hospitalised for cirrhosis.

    • Patricia C Valery, Steven McPhail, Katherine A Stuart, Gunter Hartel, Paul J Clark, James O'Beirne, Richard Skoien, Tony Rahman, Chris Moser, and Elizabeth E Powell.
    • Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
    • Intern Med J. 2021 May 1; 51 (5): 691-698.

    BackgroundThe 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.AimsTo examine the temporal change in aetiology of liver disease and presence of comorbidity in patients admitted with cirrhosis.MethodsPopulation-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.ResultsThe 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.ConclusionsAlcohol 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.© 2020 Royal Australasian College of Physicians.

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