Trends in hospitalizations for chronic liver disease-related liver failure in the United States, 2005-2014
Trends in hospitalizations for chronic liver disease-related liver failure in the United States, 2005-2014
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DOI：
10.1111/liv.14135
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发表时间：
2019-09-01
影响因子：
6.7
通讯作者：
Ahmed, Aijaz
中科院分区：
文献类型：
--
作者：
Kim, Donghee;Cholankeril, George;Ahmed, Aijaz
背景与目的目前缺乏基于人群的肝衰竭或终末期肝病（ESLD）疾病负担的估计。我们调查了美国（US）ESLD患者住院和住院死亡率的近期趋势。方法对2005 - 2014年全国住院病例进行回顾性分析。我们将ESLD定义为失代偿性肝硬化或肝细胞癌（HCC），标准来自国际疾病分类第九次修订版。分析了2005年至2014年全国住院率和住院死亡率。结果失代偿期肝硬化住院率由105.3/10万上升到159.9/10万。就HCC而言，住院率从13.6/100 000增加到22.1/100 000。在非酒精性脂肪性肝病（NAFLD）相关失代偿性肝硬化患者中，住院率从13.4/10万增加到32.1/10万，年递增率为10.6%，是其他病因的两倍。失代偿期肝硬化患者中，非酒精性肝病的比例从12.7%稳步上升至20.1%，而慢性丙型肝炎（HCV）和酒精性肝病（ALD）的比例下降（HCV从29.3%降至27.6%; ALD从39.0%降至37.4%）。虽然ESLD的总体住院死亡率在研究期间下降，但NAFLD相关失代偿性肝硬化的死亡率没有显着变化。结论在慢性肝病的病因中，NAFLD在美国非HCC ESLD患者中的住院率增长最快。我们的研究强调了关注NAFLD相关住院及其对资源利用的影响的必要性。
Background & Aims Current estimates of the population-based disease burden of liver failure or end-stage liver disease (ESLD) are lacking. We investigated recent trends in hospitalizations and in-hospital mortality among patients with ESLD in the United States (US). Methods A retrospective analysis was performed utilizing the National Inpatient Sample from 2005 to 2014. We defined ESLD as either decompensated cirrhosis or hepatocellular carcinoma (HCC), criteria obtained from the International Classification of Diseases, Ninth Revision. Nationwide rates of hospitalization and in-hospital mortality were analysed from 2005 to 2014. Results Hospitalization rates for decompensated cirrhosis during this period increased from 105.3/100 000 persons to 159.9/100 000 persons. In terms of HCC, hospitalization rates increased from 13.6/100 000 to 22.1/100 000. In patients with non-alcoholic fatty liver disease (NAFLD)-related decompensated cirrhosis, the hospitalization rate increased from 13.4/100 000 to 32.1/100 000 with an annual incremental increase of 10.6%, a magnitude twofold higher than other aetiologies. The proportion of NAFLD among hospitalizations with ESLD steadily increased from 12.7% to 20.1% for decompensated cirrhosis while the proportion of chronic hepatitis C (HCV) and alcoholic liver disease (ALD) declined (from 29.3% to 27.6% for HCV; from 39.0% to 37.4% for ALD). Although the overall in-hospital mortality rates for ESLD declined during the study, mortality rates for NAFLD-related decompensated cirrhosis showed no significant change. Conclusions Among aetiologies of chronic liver disease, NAFLD demonstrated the fastest growing rate of hospitalizations in non-HCC patients with ESLD in the US. Our study highlights the need for a focus on NAFLD-related hospitalizations and its impact on resource utilization.