The study includes data from 250 million hospital admissions and a follow-up period of 14 years. Although the data comes from Germany, Austria and Germany are very similar in terms of hospital stays and alcohol consumption.
“Cirrhosis, in which functional liver tissue is lost and scarred, is the common end stage of most chronic liver diseases and the fourth most common cause of death in Central Europe,” writes the Goethe University on the study led by Jonel Trebicka from the University Hospital Frankfurt am Main in the journal The Lancet has been published.
Deadliest chronic disease in the hospital
The research team analyzed the data from regarding 250 million hospital admissions that took place in Germany from 2005 to 2018 for any reason. 0.94 percent of these hospitalizations were attributed to the diagnosis of liver cirrhosis – in the majority of cases as an accompanying disease and not as the main disease.
Mortality from liver cirrhosis in hospital was primarily examined. Although this mortality rate fell from 11.57 percent to 9.49 percent during the observation period, it was significantly higher than the mortality rate in hospital following admission due to other diseases: 8.4 percent of those hospitalized died from chronic heart failure, and 8.4 percent died from kidney failure 6.4 percent and finally 5.2 percent because of chronic obstructive pulmonary disease/COPD.
“If cirrhosis of the liver occurred concomitantly with another chronic disease, then it increased its mortality rate by two to three times, most notably in infectious respiratory diseases,” said the university.
Alcohol-related cirrhosis predominates
Thanks to the introduction of directly effective antiviral drugs once morest hepatitis C diseases a few years ago, the proportion of HCV-related cirrhosis in the observation period has been reduced to almost a third. Chronic hepatitis C can almost always be cured within a few weeks with these drugs. Conversely, the frequency of cirrhosis caused by non-alcoholic fatty liver disease (NASH) has quadrupled during this period, in parallel with an increase in patients with morbid obesity (obesity).
However, unaffected by these shifts, cirrhosis caused by alcohol abuse continued to dominate. “They account for 52 percent of all cirrhosis cases recorded in the study, and the absolute numbers are increasing,” say the study authors.
Two thirds of those affected are men
Compared to other chronic diseases, the patients hospitalized with cirrhosis were significantly younger: half of them were under 64 years of age. Two-thirds of them were men. “The results of our study show that decision-makers and health care payers should invest much more in the prevention of alcohol-related liver cirrhosis,” Trebicka summarized the facts.
Austria and Germany are similar in key respects: in 2019, per capita alcohol consumption of 12.8 liters was registered in Germany, Austria was behind with an average of 11.9 liters, but was also relatively “far ahead” in Europe. With 252 hospital discharges per 1,000 inhabitants (all causes), Germany topped the OECD list in this area in 2019, Austria followed in second place with 253 hospital admissions per 1,000 inhabitants.
