Liver disease referrals to an urban, hospital-based hepatology outpatient clinic over the past 25 years.

Autor: Grubert Van Iderstine M; Section of Hepatology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada., Iluz-Freundlich D; Section of Hepatology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada., Dolovich C; Section of Hepatology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada., Villarin E; Section of Hepatology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada., Minuk GY; Section of Hepatology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada.; Department of Pharmacology and Therapeutics, Rady College of Medicine University of Manitoba Winnipeg Manitoba Canada.
Jazyk: angličtina
Zdroj: JGH open : an open access journal of gastroenterology and hepatology [JGH Open] 2019 Dec 05; Vol. 4 (3), pp. 484-489. Date of Electronic Publication: 2019 Dec 05 (Print Publication: 2020).
DOI: 10.1002/jgh3.12286
Abstrakt: Background: Additional hepatologists are required to manage the rapidly increasing number of patients with liver disease. One disincentive to trainees considering a career in hepatology is the longstanding perception that outpatient hepatology consists largely of managing patients with alcohol-induced liver disease (ALD).
Objectives: To document the types of liver diseases and changes in liver disease referrals to an urban outpatient liver disease clinic over the past 25 years.
Methods: The nature of the liver disorder, age, gender, and socioeconomic status of patients referred to an urban, hospital-based, liver diseases outpatient program were documented from 1992 to 2017. Joinpoint analysis was performed to identify significant trends in referral prevalence rates of various disorders.
Results: In 1992/1993, hepatitis C virus (HCV), followed by hepatitis B virus (HBV), "other", non-alcoholic fatty liver disease (NAFLD), and primary biliary cholangitis (PBC) were the most common underlying liver diseases in referred patients (39, 36, 12, 4.5, and 3.5% respectively), whereas in 2016/2017, NAFLD, HBV, HCV, "other," and ALD were most common (60, 15, 12, 8.7, and 3.3%, respectively). Aside from NAFLD referrals, which consistently increased over the 25-year period, the prevalence of all other liver disease referrals fluctuated but generally declined. Recently referred patients were significantly older (38 ± 13 years in 1992/1993 and 49 ± 15 years in 2016/2017, P  < 0.0001), while gender and socioeconomic status have not changed.
Conclusions: Hepatology is a diverse, dynamic subspecialty where ALD continues to constitute less than 5% of all patient referrals.
(© 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE