Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018)
Summary: 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 wa...
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2022
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oai:doaj.org-article:b348eaecfedd40f7a6c13bcabb5d18af2021-12-02T05:04:20ZTrends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018)2666-776210.1016/j.lanepe.2021.100240https://doaj.org/article/b348eaecfedd40f7a6c13bcabb5d18af2022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S266677622100226Xhttps://doaj.org/toc/2666-7762Summary: 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.Wenyi GuHannah HortlikHans-Peter ErasmusLouisa SchaafYasmin ZelekeFrank E. UschnerPhilip FerstlMartin SchulzKai-Henrik PeifferAlexander QueckTilman SauerbruchMaximilian Joseph BrolGernot RohdeCristina SanchezRichard MoreauVicente ArroyoStefan ZeuzemChristoph WelschJonel TrebickaElsevierarticlecirrhosishospital admissionmalemortalityPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Europe, Vol 12, Iss , Pp 100240- (2022) |
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| topic |
cirrhosis hospital admission male mortality Public aspects of medicine RA1-1270 |
| spellingShingle |
cirrhosis hospital admission male mortality Public aspects of medicine RA1-1270 Wenyi Gu Hannah Hortlik Hans-Peter Erasmus Louisa Schaaf Yasmin Zeleke Frank E. Uschner Philip Ferstl Martin Schulz Kai-Henrik Peiffer Alexander Queck Tilman Sauerbruch Maximilian Joseph Brol Gernot Rohde Cristina Sanchez Richard Moreau Vicente Arroyo Stefan Zeuzem Christoph Welsch Jonel Trebicka Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018) |
| description |
Summary: 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. |
| format |
article |
| author |
Wenyi Gu Hannah Hortlik Hans-Peter Erasmus Louisa Schaaf Yasmin Zeleke Frank E. Uschner Philip Ferstl Martin Schulz Kai-Henrik Peiffer Alexander Queck Tilman Sauerbruch Maximilian Joseph Brol Gernot Rohde Cristina Sanchez Richard Moreau Vicente Arroyo Stefan Zeuzem Christoph Welsch Jonel Trebicka |
| author_facet |
Wenyi Gu Hannah Hortlik Hans-Peter Erasmus Louisa Schaaf Yasmin Zeleke Frank E. Uschner Philip Ferstl Martin Schulz Kai-Henrik Peiffer Alexander Queck Tilman Sauerbruch Maximilian Joseph Brol Gernot Rohde Cristina Sanchez Richard Moreau Vicente Arroyo Stefan Zeuzem Christoph Welsch Jonel Trebicka |
| author_sort |
Wenyi Gu |
| title |
Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018) |
| title_short |
Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018) |
| title_full |
Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018) |
| title_fullStr |
Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018) |
| title_full_unstemmed |
Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018) |
| title_sort |
trends and the course of liver cirrhosis and its complications in germany: nationwide population-based study (2005 to 2018) |
| publisher |
Elsevier |
| publishDate |
2022 |
| url |
https://doaj.org/article/b348eaecfedd40f7a6c13bcabb5d18af |
| work_keys_str_mv |
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