Rising incidence,progression and changing patterns of liver disease in Wales 1999-2019  

作　　者：Thomas Peter Ignatius Pembroke Gareth John Berry Puyk Keith Howkins Ruth Clarke Fidan Yousuf Marek Czajkowski Andrew Godkin Jane Salmon Andrew Yeoman 

机构地区：[1]Department of Gastroenterology and Hepatology,University Hospital of Wales,Cardiff CF144XN,United Kingdom [2]Division of Infection and Immunity,Cardiff University,Cardiff CF144XW,United Kingdom [3]Digital Health and Care Wales,NHS Wales,Cardiff CF119AD,United Kingdom [4]Gwent Liver Unit,Royal Gwent Hospital,Newport NP202UB,United Kingdom [5]Public Health Wales,NHS Wales,Cardiff CF104BZ,United Kingdom

出　　处：《World Journal of Hepatology》2023年第1期89-106,共18页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Liver disease incidence and hence demand on hepatology services is increasing.AIM To describe trends in incidence and natural history of liver diseases in Wales to inform effective provision of hepatology services.METHODS The registry is populated by International Classification of Diseases-10(ICD-10)code diagnoses for residents derived from mortality data and inpatient/day case activity between 1999-2019.Pseudo-anonymised linkage of:(1)Causative diagnoses;(2)Cirrhosis;(3)Portal hypertension;(4)Decompensation;and(5)Liver cancer diagnoses enabled tracking liver disease progression.RESULTS The population of Wales in 2019 was 3.1 million.Between 1999 and 201973054 individuals were diagnosed with a hepatic disorder,including 18633 diagnosed with cirrhosis,10965 with liver decompensation and 2316 with hepatocellular carcinoma(HCC).Over 21 years the incidence of liver diseases increased 3.6 fold,predominantly driven by a 10 fold increase in non-alcoholic fatty liver disease(NAFLD);the leading cause of liver disease from 2014.The incidence of cirrhosis,decompensation,HCC,and allcause mortality tripled.Liver-related mortality doubled.Alcohol-related liver disease(ArLD),autoimmune liver disease and congestive hepatopathy were associated with the highest rates of decompensation and all-cause mortality.CONCLUSION A 10 fold increase in NAFLD incidence is driving a 3.6 fold increase in liver disease in Wales over 21 years.Liver-related morbidity and mortality rose more slowly reflecting the lower progression rate in NAFLD.Incidence of ArLD remained stable but was associated with the highest rates of liver-related and all-cause mortality.

关 键 词：EPIDEMIOLOGY CIRRHOSIS Liver failure Non-alcoholic fatty liver disease hepatitis Hepatocellular carcinoma 

分 类 号：R575[医药卫生—消化系统]