Rising hospital admissions for alcohol-related cirrhosis and the impact of sex and comorbidity - a data linkage study.

Autor: Sarraf B; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia. Electronic address: babak.sarraf@health.qld.gov.au., Skoien R; Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. Electronic address: richard.skoien@health.qld.gov.au., Hartel G; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia; School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia. Electronic address: gunter.hartel@qimrberghofer.edu.au., O'Beirne J; Department of Gastroenterology and Hepatology, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia. Electronic address: james.obeirne@health.qld.gov.au., Clark PJ; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Mater Hospital Brisbane, South Brisbane, QLD, Australia; Faculty of Medicine, The University of Queensland, QLD, Australia. Electronic address: paul.j.clark@uq.edu.au., Collins L; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia. Electronic address: Louisa.Collins@qimrberghofer.edu.au., Leggett B; Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Faculty of Medicine, The University of Queensland, QLD, Australia. Electronic address: Barbara.Leggett@health.qld.gov.au., Powell EE; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, QLD, Australia. Electronic address: e.powell@uq.edu.au., Valery PC; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Faculty of Medicine, The University of Queensland, QLD, Australia. Electronic address: Patricia.Valery@qimrberghofer.edu.au.
Jazyk: angličtina
Zdroj: Public health [Public Health] 2024 Jul; Vol. 232, pp. 178-187. Date of Electronic Publication: 2024 May 24.
DOI: 10.1016/j.puhe.2024.04.030
Abstrakt: Objectives: International studies have shown shifting demographic data and rising hospitalizations for alcohol-related cirrhosis (ARC), with a paucity of data from Australia. We examined hospitalizations, mortality and demographic data for people admitted with ARC over the last decade in Queensland, Australia.
Study Design: Data linkage study.
Methods: A retrospective analysis of adults hospitalized with ARC during 2008-2019 was performed using state-wide admissions data. International Classification of Diseases, 10th revision, codes identified admissions with the principal diagnosis of ARC based on validated algorithms. Comorbidity was assessed using the Charlson Comorbidity Index.
Results: A total of 7152 individuals had 24,342 hospital admissions with ARC (16,388 were for ARC). There was a predominance of males (72.6%) and age ≥50 years (80.4%) at index admission. Females were admitted at a significantly younger age than men (59% of women and 43% of men were aged <60 years, P < 0.001). Comorbidities were common, with 45.1% of people having at least one comorbidity. More than half (54.6%) of the patients died over the study period (median follow-up time was 5.1 years; interquartile range 2.4-8.6). Women had significantly lower mortality, with 47.6% (95% confidence interval [CI] 45.0-50.2) probability of 5-year survival, compared with 40.1% (95% CI 38.5-41.6) in men. In multivariable analysis, this was attributable to significantly lower age and comorbidity burden in women. Significantly lower survival was seen in people with higher comorbidity burden. Overall, the number of admissions for ARC increased 2.2-fold from 869 admissions in 2008 to 1932 in 2019.
Conclusions: Hospital admissions for ARC have risen substantially in the last decade. Females were admitted at a younger age, with fewer comorbidities and had lower mortality compared with males. The association between greater comorbidity burden and higher mortality has important clinical implications, as comorbidity-directed interventions may reduce mortality.
(Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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