The effect of the COVID-19 pandemic on hospitalizations of cirrhotic patients

IF 4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
{"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&lt;.0001), while hospitalizations for alcohol-related cirrhosis significantly increased (31% vs. 52%; P&lt;.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.

COVID-19 大流行对肝硬化患者住院治疗的影响
引言SARS-CoV-2的传播给全球医疗系统造成了巨大压力,需要对医疗资源进行彻底重组。此外,COVID-19住院患者肝病严重程度的上升也是一个令人严重关切的问题,因为这可能会导致未来更多人群的健康状况恶化。我们的目的是全面概述COVID-19对意大利阿布鲁佐地区地方卫生局1(LHB1)医院肝硬化患者的每月住院率、临床损害、住院时间(LoS)和死亡率的影响。材料和方法我们采用《国际疾病分类第九版-临床修正》(ICD-9-CM)确定了酒精相关性肝硬化、非酒精相关性肝硬化和失代偿性肝硬化病例。我们分析了 2019 年 1 月 1 日至 2019 年 12 月 31 日(大流行前)和 2022 年 1 月 1 日至 2022 年 12 月 31 日(大流行后)的 957 份出院记录(HDR),并评估了大流行前后患者的临床损害、LoS 和死亡率。与大流行前相比,大流行后非酒精相关性肝硬化的住院率显著下降(69% 对 48%;P< .0001),而酒精相关性肝硬化的住院率显著上升(31% 对 52%;P< .0001)。此外,与酒精相关的肝硬化失代偿期患者在大流行后也明显增加(77% 对 65%;P=.0216)。结论我们的研究指出了大流行导致的肝硬化患者住院率和预后的重要差异,进一步强调了酒精相关性肝硬化住院人数的急剧增加。由于这将对阿布鲁佐地区慢性肝病的自然病史产生长期影响,因此必须继续提高人们的认识,加强预防策略和个性化随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Digestive and Liver Disease
Digestive and Liver Disease 医学-胃肠肝病学
CiteScore
6.10
自引率
2.20%
发文量
632
审稿时长
19 days
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信