Files and links (2)
Increasing Hospitalization Rates for Cirrhosis-Overrepresentation of Disadvantaged Australians653.52 kB
Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Increasing Hospitalization Rates for Cirrhosis: Overrepresentation of Disadvantaged Australians
EClinicalMedicine, Vol.11, pp.44-53
2019
PMCID: PMC6610783
PMID: 31317132
Abstract
Background: Limited information is available about hospitalization rates for cirrhosis in Australia.
Methods: Using information on all hospital episodes of care for patients admitted to Queensland hospitals during 2008–2016, we report age-standardized hospitalization rates/10,000 person-years, in-hospital case-fatality rate among these admissions (n = 30,327), and examine the factors associated with hospital deaths using logistic regression analyses.
Findings: Hospitalization rates increased from 8.50/10,000 (95% confidence interval (CI) 8.18–8.82) to 11.21/10,000 (95%CI 10.87–11.54) between 2008 and 2016, and peaked in men aged 55–59 years (34.03/10,000) and in Indigenous Australians (32.79/10,000). The number of admissions increased by 61.7% from 2701 admissions in 2008 to 4367 in 2016. During the same period, the percentage increase varied by socioeconomic disadvantage (3.2%/year in the most affluent vs. 9.4%/year in the most disadvantaged quintile; p < 0.001). Alcohol misuse was a contributing factor for cirrhosis in 55.1% of admissions, and socioeconomic disadvantage in 26.8%. The overall in-hospital case-fatality rate was 9.7% for males and 9.3% for females, and decreased in males (p < 0.001). Predictors of in-hospital mortality included hepatorenal syndrome (adjusted odds ratio (AOR) = 7.24, 95%CI 5.99–8.75), HCC (AOR = 2.53, 95%CI 2.20–2.91), hepatic encephalopathy (AOR = 1.94, 95%CI 1.61–2.34), acute peritonitis (AOR = 1.93, 95%CI 1.61–2.33), jaundice (AOR = 1.82, 95%CI 1.20–2.75), age ≥ 70 years (AOR = 1.63, 95%CI 1.38–1.92), a higher comorbidity index (p = 0.021), and residence outside of a “major city” (p < 0.001).
Interpretation: The increasing healthcare use by Australians with cirrhosis has resource and economic implications. Our data highlight the disproportionate impact of cirrhosis on Indigenous Australians and people from the most socioeconomically disadvantaged areas.
Details
- Title
- Increasing Hospitalization Rates for Cirrhosis: Overrepresentation of Disadvantaged Australians
- Authors
- Elizabeth E Powell (Author) - Princess Alexandra HospitalR Skoien (Author) - Royal Brisbane and Women's HospitalTony Rahman (Author) - Prince Charles HospitalPaul J Clark (Author) - Princess Alexandra HospitalJames O'Beirne (Author) - Sunshine Coast University HospitalGunter Hartel (Author) - QIMR Berghofer Medical Research InstituteKatherine A Stuart (Author) - Princess Alexandra HospitalSteven M McPhail (Author) - Queensland University of TechnologyRohit Gupta (Author) - Logan HospitalPeter Boyd (Author) - Cairns HospitalPatricia C Valery (Author) - QIMR Berghofer Medical Research Institute
- Publication details
- EClinicalMedicine, Vol.11, pp.44-53
- Publisher
- Lancet Publishing Group
- Date published
- 2019
- DOI
- 10.1016/j.eclinm.2019.05.007
- ISSN
- 2589-5370
- PMID
- 31317132; PMC6610783
- Copyright note
- © 2019 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
- Organisation Unit
- UniSC Clinical Trials Centre; University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 99609707802621
- Output Type
- Journal article
Metrics
1 File views/ downloads
53 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- Web Of Science research areas
- Gastroenterology & Hepatology
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites