{"title":"Evolving trends in liver cirrhosis: etiology, complications and comorbidities","authors":"","doi":"10.1016/j.dld.2024.08.021","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The epidemiology of liver cirrhosis is evolving and the etiology, complications, and comorbidities of cirrhosis are continuously changing, presenting new challenges.</p></div><div><h3>Methods</h3><p>We reported data from an observational, monocentric study including 1,617 patients with liver cirrhosis admitted to our liver unit from January 2014 to December 2023.</p></div><div><h3>Results</h3><p>The mean age of patients was 66.8 years, with a male predominance except for autoimmune etiology. During the observation period, the number of hospitalized patients with active HCV infection decreased from 47.9% in 2014 to 9.2% in 2023, while patients with HCV cirrhosis in sustained virologic response (SVR) increased from 15.6% in 2014 to 26.2% in 2023. Hospitalizations for HBV-related cirrhosis remained stable (5.5% in 2014 and 8.5% in 2023. Patients for alcohol-related cirrhosis increased from 16.6% in 2014 to 23.9% 2023 and patients with metabolic cirrhosis increased from 10.6% in 2014 to 36.8% in 2023. The rate of patients with autoimmune cirrhosis (3.0% in 2014 and 4.2% in 2023) and cryptogenic cirrhosis (6.0% in 2014 to 7.9% in 2023) remained stable over the years. Patients with alcohol-related cirrhosis (mean age 59.5 years), HBV cirrhosis (62.1 years) and autoimmune etiologies (62.2 years) were younger than patients with HCV cirrhosis (69.3 years), metabolic cirrhosis (68.3 years) and cryptogenic cirrhosis (67.6 years). The most frequent complication for hospitalization was HCC in active (47.8%) and SVR (58.2%) HCV cirrhosis, and in HBV cirrhosis (47.3%), with the ascites was more frequent in alcohol-related (45.8%) and metabolic (34.1%) cirrhosis Patients with metabolic cirrhosis had the most extrahepatic comorbidities (66.3% diabetic, 18.0% chronic kidney disease, and 20.7% heart disease).</p></div><div><h3>Conclusions</h3><p>Liver cirrhosis epidemiology is changing, with decreasing HCV infections but increasing alcohol-related and metabolic cases. Complications and comorbidities require tailored management strategies. Effective public health interventions and adaptive healthcare approaches are crucial to address these evolving challenges.</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/S159086582400940X","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
Background
The epidemiology of liver cirrhosis is evolving and the etiology, complications, and comorbidities of cirrhosis are continuously changing, presenting new challenges.
Methods
We reported data from an observational, monocentric study including 1,617 patients with liver cirrhosis admitted to our liver unit from January 2014 to December 2023.
Results
The mean age of patients was 66.8 years, with a male predominance except for autoimmune etiology. During the observation period, the number of hospitalized patients with active HCV infection decreased from 47.9% in 2014 to 9.2% in 2023, while patients with HCV cirrhosis in sustained virologic response (SVR) increased from 15.6% in 2014 to 26.2% in 2023. Hospitalizations for HBV-related cirrhosis remained stable (5.5% in 2014 and 8.5% in 2023. Patients for alcohol-related cirrhosis increased from 16.6% in 2014 to 23.9% 2023 and patients with metabolic cirrhosis increased from 10.6% in 2014 to 36.8% in 2023. The rate of patients with autoimmune cirrhosis (3.0% in 2014 and 4.2% in 2023) and cryptogenic cirrhosis (6.0% in 2014 to 7.9% in 2023) remained stable over the years. Patients with alcohol-related cirrhosis (mean age 59.5 years), HBV cirrhosis (62.1 years) and autoimmune etiologies (62.2 years) were younger than patients with HCV cirrhosis (69.3 years), metabolic cirrhosis (68.3 years) and cryptogenic cirrhosis (67.6 years). The most frequent complication for hospitalization was HCC in active (47.8%) and SVR (58.2%) HCV cirrhosis, and in HBV cirrhosis (47.3%), with the ascites was more frequent in alcohol-related (45.8%) and metabolic (34.1%) cirrhosis Patients with metabolic cirrhosis had the most extrahepatic comorbidities (66.3% diabetic, 18.0% chronic kidney disease, and 20.7% heart disease).
Conclusions
Liver cirrhosis epidemiology is changing, with decreasing HCV infections but increasing alcohol-related and metabolic cases. Complications and comorbidities require tailored management strategies. Effective public health interventions and adaptive healthcare approaches are crucial to address these evolving challenges.
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.