Alcohol-related Liver Disease is Rarely Detected at Early Stages Compared With Liver Diseases of Other Etiologies Worldwide
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Alcohol-related Liver Disease is Rarely Detected at Early Stages Compared With Liver Diseases of Other Etiologies Worldwide. / Shah, Neil D; Ventura-Cots, Meritxell; Abraldes, Juan G; Alboraie, Mohamed; Alfadhli, Ahmad; Argemi, Josepmaria; Badia-Aranda, Ester; Soler, Enrique Arus; Barritt, A Sidney; Bessone, Fernando; Biryukova, Marina; Carrilho, Flair J; Fernández, Marlen Castellanos; Guiridi, Zaily Dorta; El Kassas, Mohamed; Eng-Kiong, Teo; Farias, Alberto; George, Jacob; Gui, Wenfang; Harichander-Thurairajah, Prem; Hsiang, John Chen; Husić-Selimovic, Azra; Isakov, Vasily; Karoney, Mercy; Kim, Won; Kluwe, Johannes; Kochhar, Rakesh; Dhaka, Narendra; Costa, Pedro Marques; Nabeshima, Mariana A; Ono, Suzane K; Reis, Daniela; Rodil, Agustina; Domech, Caridad Ruenes; Sáez-Royuela, Federico; Scheurich, Christoph; Siow, Way; Sivac-Burina, Nadja; Dos Santos Traquino, Edna Solange; Some, Fatma; Spreckic, Sanjin; Tan, Shiyun; Vorobioff, Julio; Wandera, Andrew; Wu, Pengbo; Yakoub, Mohamed; Yang, Ling; Yu, Yuanjie; Zahiragic, Nerma; Zhang, Chaoqun; Cortez-Pinto, Helena; Bataller, Ramon.
in: CLIN GASTROENTEROL H, Jahrgang 17, Nr. 11, 10.2019, S. 2320-2329.e12.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Alcohol-related Liver Disease is Rarely Detected at Early Stages Compared With Liver Diseases of Other Etiologies Worldwide
AU - Shah, Neil D
AU - Ventura-Cots, Meritxell
AU - Abraldes, Juan G
AU - Alboraie, Mohamed
AU - Alfadhli, Ahmad
AU - Argemi, Josepmaria
AU - Badia-Aranda, Ester
AU - Soler, Enrique Arus
AU - Barritt, A Sidney
AU - Bessone, Fernando
AU - Biryukova, Marina
AU - Carrilho, Flair J
AU - Fernández, Marlen Castellanos
AU - Guiridi, Zaily Dorta
AU - El Kassas, Mohamed
AU - Eng-Kiong, Teo
AU - Farias, Alberto
AU - George, Jacob
AU - Gui, Wenfang
AU - Harichander-Thurairajah, Prem
AU - Hsiang, John Chen
AU - Husić-Selimovic, Azra
AU - Isakov, Vasily
AU - Karoney, Mercy
AU - Kim, Won
AU - Kluwe, Johannes
AU - Kochhar, Rakesh
AU - Dhaka, Narendra
AU - Costa, Pedro Marques
AU - Nabeshima, Mariana A
AU - Ono, Suzane K
AU - Reis, Daniela
AU - Rodil, Agustina
AU - Domech, Caridad Ruenes
AU - Sáez-Royuela, Federico
AU - Scheurich, Christoph
AU - Siow, Way
AU - Sivac-Burina, Nadja
AU - Dos Santos Traquino, Edna Solange
AU - Some, Fatma
AU - Spreckic, Sanjin
AU - Tan, Shiyun
AU - Vorobioff, Julio
AU - Wandera, Andrew
AU - Wu, Pengbo
AU - Yakoub, Mohamed
AU - Yang, Ling
AU - Yu, Yuanjie
AU - Zahiragic, Nerma
AU - Zhang, Chaoqun
AU - Cortez-Pinto, Helena
AU - Bataller, Ramon
N1 - Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - BACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies.METHODS: We performed a cross-sectional study of 3453 consecutive patients with either early or advanced liver disease (1699 patients with early and 1754 with advanced liver disease) seen at 17 tertiary care liver or gastrointestinal units worldwide, from August 2015 through March 2017. We collected anthropometric, etiology, and clinical information, as well as and model for end-stage liver disease scores. We used unconditional logistic regression to estimate the odds ratios for evaluation at late stages of the disease progression.RESULTS: Of the patients analyzed, 81% had 1 etiology of liver disease and 17% had 2 etiologies of liver disease. Of patients seen at early stages for a single etiology, 31% had HCV infection, 21% had hepatitis B virus infection, and 17% had nonalcoholic fatty liver disease, whereas only 3.8% had ALD. In contrast, 29% of patients seen for advanced disease had ALD. Patients with ALD were more likely to be seen at specialized centers, with advanced-stage disease, compared with patients with HCV-associated liver disease (odds ratio, 14.1; 95% CI, 10.5-18.9; P < .001). Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. These patients had significantly more visits to health care providers, with more advanced disease, compared with patients without excess alcohol use. The mean model for end-stage liver disease score for patients with advanced ALD (score, 16) was higher than for patients with advanced liver disease not associated with excess alcohol use (score, 13) (P < .01).CONCLUSIONS: In a cross-sectional analysis of patients with liver disease worldwide, we found that patients with ALD are seen with more advanced-stage disease than patients with HCV-associated liver disease. Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. Early detection and referral programs are needed for patients with ALD worldwide.
AB - BACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies.METHODS: We performed a cross-sectional study of 3453 consecutive patients with either early or advanced liver disease (1699 patients with early and 1754 with advanced liver disease) seen at 17 tertiary care liver or gastrointestinal units worldwide, from August 2015 through March 2017. We collected anthropometric, etiology, and clinical information, as well as and model for end-stage liver disease scores. We used unconditional logistic regression to estimate the odds ratios for evaluation at late stages of the disease progression.RESULTS: Of the patients analyzed, 81% had 1 etiology of liver disease and 17% had 2 etiologies of liver disease. Of patients seen at early stages for a single etiology, 31% had HCV infection, 21% had hepatitis B virus infection, and 17% had nonalcoholic fatty liver disease, whereas only 3.8% had ALD. In contrast, 29% of patients seen for advanced disease had ALD. Patients with ALD were more likely to be seen at specialized centers, with advanced-stage disease, compared with patients with HCV-associated liver disease (odds ratio, 14.1; 95% CI, 10.5-18.9; P < .001). Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. These patients had significantly more visits to health care providers, with more advanced disease, compared with patients without excess alcohol use. The mean model for end-stage liver disease score for patients with advanced ALD (score, 16) was higher than for patients with advanced liver disease not associated with excess alcohol use (score, 13) (P < .01).CONCLUSIONS: In a cross-sectional analysis of patients with liver disease worldwide, we found that patients with ALD are seen with more advanced-stage disease than patients with HCV-associated liver disease. Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. Early detection and referral programs are needed for patients with ALD worldwide.
KW - Journal Article
U2 - 10.1016/j.cgh.2019.01.026
DO - 10.1016/j.cgh.2019.01.026
M3 - SCORING: Journal article
C2 - 30708110
VL - 17
SP - 2320-2329.e12
JO - CLIN GASTROENTEROL H
JF - CLIN GASTROENTEROL H
SN - 1542-3565
IS - 11
ER -