A222 Increasing Prevalence of Cirrhosis in Ontario Over the Last 20 Years: A Population-Based Study

Saperia, James; DeWit, Yvonne; Booth, Chris; Groome, Patti A.; Flemming, Jennifer A.

doi:10.1093/jcag/gwy008.223

Cited by 2 publications

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“…Cirrhosis and hepatocellular carcinoma (HCC) are important causes of mortality and morbidity, the impact of which are rising over time in all jurisdictions 1 . Ontario, Canada's most populous province, confirmed increases in cirrhosis prevalence from 20.7/10 000 in 1992 to 120/10 000 in 2012, 2 and increases in HCC incidence from 0.22/10 000 in 1984 to 0.65/10 000 in 2013 3,4 . Hospitalisation for patients with liver disease in North America is managed primarily by internal medicine or hospitalist teams.…”

Section: Introductionmentioning

confidence: 99%

Internal medicine hospitalisations and liver disease: a comparative disease burden analysis of a multicentre cohort

Roberts

Hansen

Shin

et al. 2021

Aliment Pharmacol Ther

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Summary Background Liver disease is an increasing burden on population health globally. Aims To characterise burden of liver disease among general internal medicine inpatients at seven Toronto‐area hospitals and compare it to other common medical conditions. Methods Data from April 2010 to October 2017 were obtained from hospitals participating in the GEMINI collaborative. Using these cohort data from hospital information systems linked to administrative data, we defined liver disease admissions using most responsible discharge diagnoses categorised according to international classification of diseases, 10th Revision—enhanced Canadian version (ICD‐10‐CA). We identified admissions for heart failure, chronic obstructive pulmonary disease (COPD) and pneumonia as comparators. We calculated standardised mortality ratios (SMRs) as the ratio of observed to expected deaths. Results Among 239 018 discharges, liver disease accounted for 1.7% of most responsible discharge diagnoses. Liver disease was associated with marked premature mortality, with SMR of 8.84 (95% CI 8.06‐9.67) compared to 1.06 (95% CI 0.99‐1.12) for heart failure, 1.05 (95% CI 0.96‐1.15) for COPD and 1.28 (95% CI 1.20‐1.37) for pneumonia. The majority of deaths were among patients younger than 65 years (57.7%) compared to 3.3% in heart failure, 5.6% in COPD and 10.7% in pneumonia. Liver disease patients presented with worse Laboratory‐Based Acute Physiology Scores, were more frequently admitted to the intensive care unit (14.4%), incurred higher average total costs (median $6723 CAD), had higher in‐hospital mortality (11.4%), and were more likely to be a readmission from 30 days prior (19.8%). Non‐alcoholic fatty liver disease admissions increased from 120 in 2011‐2012 to 215 in 2016‐2017 (P < 0.01). Conclusion In Canada's largest urban centre, liver disease admissions resulted in premature morbidity and mortality with higher resource use compared to common cardio‐respiratory conditions. Re‐evaluation of approaches to caring for inpatients with liver disease is timely and justified.

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Section: Introductionmentioning

confidence: 99%

Internal medicine hospitalisations and liver disease: a comparative disease burden analysis of a multicentre cohort

Roberts

Hansen

Shin

et al. 2021

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…We hope that our study spurs dialogues tailored to specific local healthcare needs that focus on changing why, and how we deliver care for patients with liver disease. We are in the process of initiating such work in Toronto and recognise that clinical teams elsewhere are equally focused on the very real challenge of the increasing incidence of liver disease in Canada 7,8 and beyond 9,10 …”

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confidence: 99%