Ontology highlight
ABSTRACT: Background
Cirrhosis is known to have a high prevalence and mortality worldwide. However, in Europe, the epidemiology of cirrhosis is possibly undergoing demographic changes, and etiologies may have changed due to improvements in standard of care. The aim of this population-based study was to analyze the trends and the course of liver cirrhosis and its complications in recent years in Germany.Methods
We analyzed the data of all hospital admissions in Germany within diagnosis-related groups from 2005 to 2018. The diagnostic records of cirrhosis and other categories of diseases were based on ICD-10-GM codes. The primary outcome measurement was in-hospital mortality. Trends were analyzed through Poisson regression of annual number of admissions. The impact of cirrhosis on overall in-hospital mortality were assessed through the multivariate multilevel logistic regression model adjusted for age, sex, and comorbidities.Findings
Of the 248,085,936 admissions recorded between 2005 and 2018, a total of 2,302,171(0•94%) were admitted with the diagnosis of cirrhosis, mainly as a comorbidity. Compared with other chronic diseases, patients admitted with cirrhosis were younger, mainly male and had the highest in-hospital mortality rate. Diagnosis of cirrhosis was an independent risk factor of in-hospital mortality with the highest odds ratio (OR:6•2[95%CI:6.1-6•3]) among all diagnoses. The prevalence of non-alcoholic fatty liver disease has increased four times from 2005 to 2018, while alcoholic cirrhosis is 20 times than other etiologies. Bleeding was found to be decreasing over time, but ascites remained the most common complication and was increasing.Interpretation
This nationwide study demonstrates that cirrhosis represents a considerable healthcare burden, as shown by the increasing in-hospital mortality, also in combination with other chronic diseases. Alcohol-related cirrhosis and complications are on the rise. More resources and better management strategies are warranted.Funding
The funders had no influence on this study.
SUBMITTER: Gu W
PROVIDER: S-EPMC8640738 | biostudies-literature | 2022 Jan
REPOSITORIES: biostudies-literature
Gu Wenyi W Hortlik Hannah H Erasmus Hans-Peter HP Schaaf Louisa L Zeleke Yasmin Y Uschner Frank E FE Ferstl Philip P Schulz Martin M Peiffer Kai-Henrik KH Queck Alexander A Sauerbruch Tilman T Brol Maximilian Joseph MJ Rohde Gernot G Sanchez Cristina C Moreau Richard R Arroyo Vicente V Zeuzem Stefan S Welsch Christoph C Trebicka Jonel J
The Lancet regional health. Europe 20211104
<h4>Background</h4>Cirrhosis is known to have a high prevalence and mortality worldwide. However, in Europe, the epidemiology of cirrhosis is possibly undergoing demographic changes, and etiologies may have changed due to improvements in standard of care. The aim of this population-based study was to analyze the trends and the course of liver cirrhosis and its complications in recent years in Germany.<h4>Methods</h4>We analyzed the data of all hospital admissions in Germany within diagnosis-rela ...[more]