Chronic liver disease--an increasing problem: a study of hospital admission and mortality rates in England, 1979-2005, with particular reference to alcoholic liver disease.
OBJECTIVE
To determine time trends in hospital admissions for chronic liver disease in England between 1989/1990 and 2002/2003, mortality rates in England and Wales between 1979 and 2005, and the influence of alcohol-related disease on these trends.


METHODS
Hospital episode statistics for admissions in England were obtained from the Information Center for Health and Social Care and mortality data for England and Wales from the Office for National Statistics.


RESULTS
Hospital admission rates for chronic liver disease increased by 71% in males and 43% in females over the study period. This increase was largely due to alcoholic liver disease, admission rates for which more than doubled between 1989/1990 and 2002/2003. While there was a smaller rise for chronic viral hepatitis B and C, admission rates declined for hepatitis A, autoimmune hepatitis, and primary biliary cirrhosis. Mortality rates for chronic liver disease more than doubled between 1979 and 2005. Two thirds of these deaths were attributable to alcohol-related liver disease in 2005. The highest rate of alcoholic liver disease mortality was in the 45-64 age group, and the largest percentage increase between 1979 and 2005 occurred in the 25-34 age group.


CONCLUSIONS
Hospital admissions and mortality in England from chronic liver disease are increasing. The underlying reasons are complex, but alcohol-induced liver disease makes a major contribution. There are clear social and health implications if the trend continues and addressing alcohol-related liver disease should be a public health priority.
Thomson
Sam J
SJ
Department of Gastroenterology and Hepatology, St George's Hospital, Blackshaw Rd, London, England, SW17 0QT, UK.
Westlake
Susan
S
Rahman
Tony M
TM
Cowan
Matthew L
ML
Majeed
Azeem
A
Maxwell
J Douglas
JD
Kang
Jin-Yong
JY
D000328:Adult; D002908:Chronic Disease; D004739:England / Q000453:epidemiology; D005260:Female; D006506:Hepatitis A / Q000401:mortality / Q000534:rehabilitation; D006509:Hepatitis B / Q000401:mortality / Q000534:rehabilitation; D006526:Hepatitis C / Q000401:mortality / Q000534:rehabilitation; D019693:Hepatitis, Autoimmune / Q000401:mortality / Q000534:rehabilitation; D006801:Humans; D015994:Incidence; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology* / Q000401:mortality / Q000534:rehabilitation*; D008107:Liver Diseases / Q000453:epidemiology* / Q000401:mortality / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D014852:Wales / Q000453:epidemiology