{"title":"The effect of the COVID-19 pandemic on hospitalizations of cirrhotic patients","authors":"","doi":"10.1016/j.dld.2024.08.020","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The spread of SARS-CoV-2 has strained the global health system, necessitating a radical reorganization of health resources. In addition, the escalation in liver disease severity among hospitalized COVID-19 patients is a matter of serious concern, as it may lead to the deterioration of health outcomes for a larger population in the future.</p></div><div><h3>Aim</h3><p>We aimed at providing a comprehensive overview of COVID-19 impact on monthly hospitalization rates, clinical impairment, Length of Stay (LoS), and mortality of cirrhotic patients admitted to the Local Health Board 1 (LHB1) hospitals in the Abruzzo Region, Italy.</p></div><div><h3>Materials and Methods</h3><p>Using the International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM), we identified cases of alcohol-related cirrhosis, nonalcohol-related cirrhosis, and decompensated cirrhosis. We analysed 957 Hospital Discharge Records (HDR) from January 1, 2019, to December 31, 2019 (pre-pandemic), and from January 1, 2022, to December 31, 2022 (post-pandemic) and we evaluated patients' clinical impairment, LoS, and mortality before and after the pandemic.</p></div><div><h3>Results</h3><p>We identified 494 hospitalizations for nonalcohol-related cirrhosis and 310 for alcohol-related cirrhosis. In the post-pandemic period, hospitalizations for nonalcohol-related cirrhosis significantly decreased (69% vs. 48%; P<.0001), while hospitalizations for alcohol-related cirrhosis significantly increased (31% vs. 52%; P<.0001) compared to pre-pandemic. Additionally, the decompensated patients with alcohol-related cirrhosis significantly increased in the post-pandemic period (77% vs. 65%; P=.0216). Mortality risk significantly increased for both nonalcohol-related (11% vs. 18.5%; P=.0176) and alcohol-related cirrhosis (7.7% vs. 18%; P=.0059) in the post-pandemic era.</p></div><div><h3>Conclusions</h3><p>Our study pointed out important differences in hospitalization rates and outcomes of cirrhotic patients due to the pandemic, further highlighting the dramatic increase in hospitalizations for alcohol-related cirrhosis. Since this will have a prolonged impact on the natural history of chronic liver disease in Abruzzo Region, continued awareness as well as enhancement of prevention strategies and personalized follow-ups, will be essential.</p></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive and Liver Disease","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1590865824009393","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
The spread of SARS-CoV-2 has strained the global health system, necessitating a radical reorganization of health resources. In addition, the escalation in liver disease severity among hospitalized COVID-19 patients is a matter of serious concern, as it may lead to the deterioration of health outcomes for a larger population in the future.
Aim
We aimed at providing a comprehensive overview of COVID-19 impact on monthly hospitalization rates, clinical impairment, Length of Stay (LoS), and mortality of cirrhotic patients admitted to the Local Health Board 1 (LHB1) hospitals in the Abruzzo Region, Italy.
Materials and Methods
Using the International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM), we identified cases of alcohol-related cirrhosis, nonalcohol-related cirrhosis, and decompensated cirrhosis. We analysed 957 Hospital Discharge Records (HDR) from January 1, 2019, to December 31, 2019 (pre-pandemic), and from January 1, 2022, to December 31, 2022 (post-pandemic) and we evaluated patients' clinical impairment, LoS, and mortality before and after the pandemic.
Results
We identified 494 hospitalizations for nonalcohol-related cirrhosis and 310 for alcohol-related cirrhosis. In the post-pandemic period, hospitalizations for nonalcohol-related cirrhosis significantly decreased (69% vs. 48%; P<.0001), while hospitalizations for alcohol-related cirrhosis significantly increased (31% vs. 52%; P<.0001) compared to pre-pandemic. Additionally, the decompensated patients with alcohol-related cirrhosis significantly increased in the post-pandemic period (77% vs. 65%; P=.0216). Mortality risk significantly increased for both nonalcohol-related (11% vs. 18.5%; P=.0176) and alcohol-related cirrhosis (7.7% vs. 18%; P=.0059) in the post-pandemic era.
Conclusions
Our study pointed out important differences in hospitalization rates and outcomes of cirrhotic patients due to the pandemic, further highlighting the dramatic increase in hospitalizations for alcohol-related cirrhosis. Since this will have a prolonged impact on the natural history of chronic liver disease in Abruzzo Region, continued awareness as well as enhancement of prevention strategies and personalized follow-ups, will be essential.
期刊介绍:
Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).
Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology.
Contributions consist of:
Original Papers
Correspondence to the Editor
Editorials, Reviews and Special Articles
Progress Reports
Image of the Month
Congress Proceedings
Symposia and Mini-symposia.