The Epidemiology of Acute Liver Failure.


Journal

Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967

Informations de publication

Date de publication:
24 01 2020
Historique:
received: 30 01 2019
revised: 30 01 2019
accepted: 14 11 2018
entrez: 11 2 2020
pubmed: 11 2 2020
medline: 15 4 2020
Statut: ppublish

Résumé

Acute liver failure (ALF) is a life-threatening event associated with high mortality. Currently, only estimates are available for its incidence. The aim of the study was to assess the incidence of ALF in Germany, using the accounting data of the largest statutory health insurance company, which represents 26.5 million people. The analysis included patients insured from 1 January 2014 to 31 December 2018. Coding with the International Statistical Classification of Diseases and Related Health Problems and the German operation and procedure codes were used to identify the patients, whose age, sex, liver transplantations (LT), and fatal outcomes were then recorded and extrapolated to the total population. As a validity check, the extrapolated LT results were compared with the LT that were actually performed. The calculated incidence of ALF was 1.13/100 000 person-years, representing 4652 cases. Women were more often affected (52% versus 48%, p < 0.001). The overall rate of mortality within 3 months was 47%. A total of 203 LT were recorded in 176 patients. Men received 41% of the LT, women 59% (p < 0.137). The 1-year overall mortality rate after LT was 20%. The 203 calculated transplantations corresponded to 228 actually performed transplantations. The incidence of ALF was higher than previously estimated for Germany, with only a very low rate of LT despite high mortality. When extrapolating ny, it must be borne in mind that those insured by the company concerned do not represent a valid sample.

Sections du résumé

BACKGROUND
Acute liver failure (ALF) is a life-threatening event associated with high mortality. Currently, only estimates are available for its incidence. The aim of the study was to assess the incidence of ALF in Germany, using the accounting data of the largest statutory health insurance company, which represents 26.5 million people.
METHODS
The analysis included patients insured from 1 January 2014 to 31 December 2018. Coding with the International Statistical Classification of Diseases and Related Health Problems and the German operation and procedure codes were used to identify the patients, whose age, sex, liver transplantations (LT), and fatal outcomes were then recorded and extrapolated to the total population. As a validity check, the extrapolated LT results were compared with the LT that were actually performed.
RESULTS
The calculated incidence of ALF was 1.13/100 000 person-years, representing 4652 cases. Women were more often affected (52% versus 48%, p < 0.001). The overall rate of mortality within 3 months was 47%. A total of 203 LT were recorded in 176 patients. Men received 41% of the LT, women 59% (p < 0.137). The 1-year overall mortality rate after LT was 20%. The 203 calculated transplantations corresponded to 228 actually performed transplantations.
CONCLUSION
The incidence of ALF was higher than previously estimated for Germany, with only a very low rate of LT despite high mortality. When extrapolating ny, it must be borne in mind that those insured by the company concerned do not represent a valid sample.

Identifiants

pubmed: 32036852
pii: arztebl.2020.0043
doi: 10.3238/arztebl.2020.0043
pmc: PMC7036472
doi:
pii:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

43-50

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Références

Medicine (Baltimore). 2014 Jun;93(4):e35
pubmed: 25068951
J Hepatol. 2017 Mar;66(3):537-544
pubmed: 27773614
Gastroenterology. 2013 Jun;144(7):1419-25, 1425.e1-3; quiz e19-20
pubmed: 23419359
Hepatol Res. 2013 Jun;43(6):630-8
pubmed: 23088515
Dtsch Arztebl Int. 2011 Oct;108(42):714-20
pubmed: 22114640
Hepatology. 2010 Dec;52(6):2065-76
pubmed: 20949552
J Gastroenterol. 2018 Jun;53(6):752-769
pubmed: 29030713
Lancet. 1993 Jul 31;342(8866):273-5
pubmed: 8101303
Health Syst Transit. 2014;16(2):1-296, xxi
pubmed: 25115137
Health Aff (Millwood). 2009 Mar-Apr;28(2):w294-304
pubmed: 19174391
J Hepatol. 2017 May;66(5):1047-1081
pubmed: 28417882
Am J Gastroenterol. 2015 Jul;110(7):963
pubmed: 26148253
Intern Med J. 2019 Jul;49(7):874-885
pubmed: 30479057
Gastroenterology. 2015 Jun;148(7):1353-61.e3
pubmed: 25733099
Eur J Public Health. 2014 Dec;24(6):1023-8
pubmed: 24627542
Ann Intern Med. 2016 Jun 7;164(11):724-32
pubmed: 27043883
Hepatogastroenterology. 2015 May;62(139):657-60
pubmed: 26897948
BMC Gastroenterol. 2019 Jan 28;19(1):18
pubmed: 30691414
Gastroenterology. 2005 Aug;129(2):512-21
pubmed: 16083708
Hepatology. 1995 Jan;21(1):240-52
pubmed: 7806160
Liver Transpl. 2007 Oct;13(10):1389-95
pubmed: 17370334
Gesundheitswesen. 2012 May;74(5):291-7
pubmed: 21755492
Vet Hum Toxicol. 2002 Aug;44(4):216-7
pubmed: 12136967
Gastroenterology. 2008 Dec;135(6):1924-34, 1934.e1-4
pubmed: 18955056
Clin Gastroenterol Hepatol. 2016 Aug;14(8):1199-1206.e2
pubmed: 27085756
Visc Med. 2016 Apr;32(2):80-5
pubmed: 27413724
Am J Gastroenterol. 2018 Sep;113(9):1319
pubmed: 29946176
PLoS One. 2013 Nov 22;8(11):e80991
pubmed: 24278360
J Hepatol. 2012 Aug;57(2):288-96
pubmed: 22521347
Lancet. 2010 Jul 17;376(9736):190-201
pubmed: 20638564
Transplantation. 2014 Sep 15;98(5):557-62
pubmed: 24717221
Clin Gastroenterol Hepatol. 2012 Jun;10(6):664-9.e2
pubmed: 22373724
J Intern Med. 2007 Sep;262(3):393-401
pubmed: 17697161
Gastroenterology. 2019 Jun;156(8):2230-2241.e11
pubmed: 30742832
QJM. 2011 Nov;104(11):945-56
pubmed: 21729878

Auteurs

Nina Weiler (N)

Department of Medicine 1, Frankfurt University Hospital, Frankfurt am Main; WIdO - AOK Research Institute, Berlin; Department of General and Visceral Surgery, Frankfurt University Hospital, Frankfurt am Main.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH