Ten years of hospital admissions for liver cirrhosis in Portugal.
OBJECTIVE
More data on epidemiology of liver diseases in Europe are needed. We aimed to characterize hospital admissions for liver cirrhosis in Portugal during the past decade.


METHODS
We analyzed all hospital admissions for cirrhosis in Portugal Mainland between 2003 and 2012 registered in the national Diagnosis-Related Group database. Cirrhosis was classified according to etiology considering alcohol, hepatitis B, and hepatitis C.


RESULTS
Between 2003 and 2012, there were 63,910 admissions for cirrhosis in Portugal Mainland; 74.4% involved male patients. Etiologies of admitted cirrhosis were as follows: 76.0% alcoholic, 1.1% hepatitis B, 1.4% hepatitis B plus alcohol, 3.6% hepatitis C, and 4.0% hepatitis C plus alcohol. There was a significant decline (P<0.001) in admissions for alcoholic cirrhosis, whereas hospitalizations for cirrhosis caused by hepatitis C or hepatitis C plus alcohol increased by almost 50% (P<0.001). Patients admitted with alcoholic plus hepatitis B or C cirrhosis were significantly younger than those with either alcoholic or viral cirrhosis (53.1 vs. 59.4 years, respectively, P<0.001). Hospitalization rates for cirrhosis were 124.4/100,000 in men and 32.6/100,000 in women. Hepatocellular carcinoma and fluid retention were more common in viral cirrhosis, whereas encephalopathy and variceal bleeding were more frequent in alcoholic cirrhosis. Hepatorenal syndrome was the strongest predictor of mortality among cirrhosis complications (odds ratio 12.97; 95% confidence interval 11.95-14.09). In-hospital mortality was 15.2%.


CONCLUSIONS
Despite the decline in admissions for alcoholic cirrhosis and the increase in those related to hepatitis C, the observed burden of hospitalized liver cirrhosis in Portugal was essentially attributable to alcoholic liver disease.
aGastroenterology Department, Central Lisbon Hospital Centre bNOVA Medical School cDirectorate of Analysis and Information, Directorate-General of Health dInstitute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Portugal.
Mário J
MJ
Silva
Matilde V
MV
Rosa
Paulo J
PJ
Nogueira
Filipe
F
Calinas
D000437:Alcoholism / Q000150:complications*; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006501:Hepatic Encephalopathy / Q000209:etiology; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006530:Hepatorenal Syndrome / Q000209:etiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D012737:Sex Factors