Mortality in biopsy-proven alcohol-related liver disease: population-based cohort study of 3,453 individuals

2020 ◽  
Vol 73 ◽  
pp. S178
Author(s):  
Hannes Hagström ◽  
Maja Thiele ◽  
Bjorn Roelstraete ◽  
Jonas Söderling ◽  
Jonas F Ludvigsson
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Population Based ◽  
Related Liver Disease

Mortality in biopsy-proven alcohol-related liver disease: a population-based nationwide cohort study of 3453 patients

Gut ◽  
2020 ◽  
Vol 70 (1) ◽  
pp. 170-179 ◽  
Author(s):  
Hannes Hagström ◽  
Maja Thiele ◽  
Bjorn Roelstraete ◽  
Jonas Söderling ◽  
Jonas F Ludvigsson
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
General Population ◽  
Liver Biopsy ◽  
Cox Regression ◽  
Population Based ◽  
Risk Of Death ◽  
Increased Risk ◽  
Related Liver Disease

ObjectivePatients with alcohol-related liver disease (ALD) are at increased risk of death, but studies have rarely investigated the significance of histological severity or estimated relative risks compared with a general population. We examined mortality in a nationwide cohort of biopsy-proven ALD.DesignPopulation-based cohort study in Sweden comparing 3453 individuals with an International Classification of Disease (ICD) code for ALD and a liver biopsy from 1969 to 2017 with 16 535 matched general population individuals. Swedish national registers were used to ascertain overall and disease-specific mortality, starting follow-up at the latest of first ICD diagnosis or liver biopsy plus 3 months. Cox regression adjusted for relevant confounders was used to estimate HRs in ALD and histopathological subgroups.ResultsMedian age at diagnosis was 58 years, 65% were men and 52% had cirrhosis at baseline. Five-year cumulative mortality was 40.9% in patients with ALD compared with 5.8% in reference individuals. The risk for overall mortality was significantly increased (adjusted HR (aHR)=4.70, 95% CI 4.35 to 5.08). The risk of liver-related death was particularly high (43% of all deaths, aHR=167.6, 95% CI 101.7 to 276.3). Mortality was significantly increased also in patients with ALD without cirrhosis and was highest in the first year after baseline but persisted after ≥10 years of follow-up (aHR=2.74, 95% CI 2.37 to 3.16).ConclusionIndividuals with biopsy-proven ALD have a near fivefold increased risk of death compared with the general population. Individuals with ALD without cirrhosis were also at increased risk of death, reaffirming the need to increase vigilance in the management of these individuals.

Repeated measures of FIB-4 improve prediction of severe liver disease: population-based cohort study of 40,729 individuals

2020 ◽  
Vol 73 ◽  
pp. S70-S71
Author(s):  
Hannes Hagström ◽  
Mats Talbäck ◽  
Anna Andreasson ◽  
Göran Walldius ◽  
Niklas Hammar
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Repeated Measures ◽  
Population Based ◽  
Severe Liver ◽  
Severe Liver Disease

scholarly journals Venous thromboembolism and subsequent risk of cancer in patients with liver disease: a population-based cohort study

2015 ◽  
Vol 2 (1) ◽  
pp. e000043 ◽  
Author(s):  
Jonathan Montomoli ◽  
Rune Erichsen ◽  
Kirstine Kobberøe Søgaard ◽  
Dóra Körmendiné Farkas ◽  
Anna-Marie Bloch Münster ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Venous Thromboembolism ◽  
Population Based ◽  
Risk Of Cancer ◽  
Subsequent Risk

Risk factors for development of severe liver disease in more than 400 000 patients with type 2 diabetes: A population-based cohort study

2018 ◽  
Vol 68 ◽  
pp. S823
Author(s):  
K. Björkström ◽  
S. Franzén ◽  
B. Eliasson ◽  
M. Miftaraj ◽  
S. Gudbjornsdottir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Liver Disease ◽  
Population Based ◽  
Severe Liver ◽  
Severe Liver Disease

S1908 Suspected Nonalcoholic Fatty Liver Disease and Mortality Risk in a Population-Based Cohort Study

2008 ◽  
Vol 134 (4) ◽  
pp. A-781-A-782 ◽  
Author(s):  
Winston Dunn ◽  
Ronghui Xu ◽  
Deborah L. Wingard ◽  
Christopher Rogers ◽  
Paul Angulo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Mortality Risk ◽  
Fatty Liver Disease ◽  
Population Based ◽  
Nonalcoholic Fatty Liver

Incidence of chronic immune-mediated inflammatory diseases after diagnosis with Kawasaki disease: a population-based cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Stephen G Fung ◽  
Richard Webster ◽  
M Ellen Kuenzig ◽  
Braden D Knight ◽  
Michelle Batthish ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cohort Study ◽  
Liver Disease ◽  
Kawasaki Disease ◽  
Sclerosing Cholangitis ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Population Based ◽  
Immune Mediated ◽  
Increased Risk

Abstract Objectives Kawasaki disease (KD) is an immune-mediated vasculitis of childhood with multi-organ inflammation. We determined the risk of subsequent immune-mediated inflammatory disease (IMID), including arthritis, type 1 diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis and multiple sclerosis. Methods We conducted a matched population-based cohort study using health administrative data from Ontario, Canada. Children aged <18 years born between 1991 and 2016 diagnosed with KD (n = 3753) were matched to 5 non-KD controls from the general population (n = 18 749). We determined the incidence of IMIDs after resolution of KD. Three- and 12-month washout periods were used to exclude KD-related symptoms. Results There was an elevated risk of arthritis in KD patients compared with non-KD controls, starting 3 months after index date [103.0 vs 12.7 per 100 000 person-years (PYs); incidence rate ratio 8.07 (95% CI 4.95, 13.2); hazard ratio 8.08 (95% CI 4.95, 13.2), resulting in the overall incidence of IMIDs being elevated in KD patients (175.1 vs 68.0 per 100 000 PYs; incidence rate ratio 2.58 (95% CI 1.93, 3.43); hazard ratio 2.58, 95% CI 1.94, 3.43]. However, there was no increased risk for diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis or multiple sclerosis in KD patients. Similar results were observed using a 12-month washout period. Conclusion Children diagnosed with KD were at increased risk of arthritis following the acute KD event, but not other IMIDs. Health-care providers should monitor for arthritis in children following a diagnosis of KD.

Obstructive sleep apnea is associated with liver disease: a population-based cohort study

2015 ◽  
Vol 16 (8) ◽  
pp. 955-960 ◽  
Author(s):  
Tzu-Chieh Chou ◽  
Wen-Miin Liang ◽  
Chang-Bi Wang ◽  
Trong-Neng Wu ◽  
Liang-Wen Hang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Liver Disease ◽  
Sleep Apnea ◽  
Population Based ◽  
Obstructive Sleep

Impact of liver disease on oral anticoagulant prescription and major adverse events in patients with atrial fibrillation: analysis from a population-based cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Proietti ◽  
I Marzona ◽  
T Vannini ◽  
P Colacioppo ◽  
M Tettamanti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Liver Disease ◽  
Risk Ratio ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Population Based ◽  
Primary Study ◽  
Secondary Bleeding ◽  
The Impact

Abstract Aims Data on the impact of liver disease (LD) in patients with atrial fibrillation (AF) and the role of oral anticoagulant (OAC) drugs for stroke prevention, are limited. We analysed the impact of LD and OAC treatment in determining stroke, major bleeding, all-cause death and secondary bleeding outcomes. Methods A retrospective observational population-based cohort study. The study cohort is derived from the administrative health databases of Lombardy region (>10 million inhabitants), Italy. All AF patients ≥40 years admitted to hospital from 2000 to 2018 were considered. AF and LD diagnosis were established using ICD9-CM codes. Use of OAC was determined with Anatomical Therapeutic Chemical (ATC) codes. Primary study outcomes were stroke, major bleeding and all-cause death. Results Among 393,507 AF patients, 16,168 (4.1%) had concomitant LD. LD AF patients were significantly less treated with OAC independent of associated clinical characteristics (OR: 0.96, 95% CI: 0.92–0.98). Concomitant LD was found associated with an increased risk in all the study outcomes (HR: 1.18, 95% CI: 1.11–1.25 for stroke; HR: 1.57, 95% CI: 1.47–1.66 for major bleeding; HR: 1.41, 95% CI: 1.39–1.44 for all-cause death. Use of OAC in patients with AF and LD resulted in a reduction in stroke (HR: 0.80, 95% CI: 0.70–0.92), major bleeding (HR: 0.86, 95% CI: 0.74–0.99) and all-cause death (HR: 0.85, 95% CI: 0.80–0.90), with similar results according to several clinically relevant subgroups. A net clinical benefit (NCB) analysis suggested a positive benefit/risk ratio in using OAC in AF patients with LD (NCB: 0.408, 95% CI: 0.375–0.472). Conclusions In AF patients, concomitant LD carries a significantly higher risk for all clinical outcomes. Use of OAC in AF patients with LD was associated with a significant benefit/risk ratio, even in high-risk patient subgroups. Funding Acknowledgement Type of funding source: None

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