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Trends in Mortality From Extrahepatic Complications in Patients With Chronic Liver Disease, From 2007 Through 2017.
Kim, Donghee; Adejumo, Adeyinka C; Yoo, Eric R; Iqbal, Umair; Li, Andrew A; Pham, Edward A; Cholankeril, George; Glenn, Jeffrey S; Ahmed, Aijaz.
Afiliação
  • Kim D; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California. Electronic address: messmd@chol.com.
  • Adejumo AC; North Shore Medical Center, Salem, Massachusetts.
  • Yoo ER; Department of Medicine, Santa Clara Valley Medical Center, San Jose, California.
  • Iqbal U; Department of Medicine, Geisinger Medical Center, Danville, Pennsylvania.
  • Li AA; Department of Medicine, Stanford University School of Medicine, Stanford, California.
  • Pham EA; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
  • Cholankeril G; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
  • Glenn JS; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
  • Ahmed A; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
Gastroenterology ; 157(4): 1055-1066.e11, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31251928
ABSTRACT
BACKGROUND &

AIMS:

Trends of mortality associated with extrahepatic complications of chronic liver disease might be changing. We studied trends in mortality from extrahepatic complications of viral hepatitis, alcoholic liver disease (ALD), and nonalcoholic fatty liver disease in the United States.

METHODS:

We performed a population-based study using US Census and the National Center for Health Statistics mortality records from 2007 through 2017. We identified trends in age-standardized mortality using Joinpoint trend analysis with estimates of annual percent change.

RESULTS:

The liver-related mortality among patients with hepatitis C virus (HCV) infection increased from 2007 through 2013 and then decreased once patients began receiving treatment with direct-acting antiviral (DAA) agents, from 2014 through 2017. Among patients with HCV infection, the age-standardized mortality for extrahepatic cancers was 2.6%, for cardiovascular disease was 1.9%, and for diabetes was 3.3%. Among individuals with hepatitis B virus infection, liver-related mortality decreased steadily from 2007 through 2017. During the study, age-standardized mortality from hepatitis B virus-related extrahepatic complications increased by an average of 2.0% each year. Although liver-related mortality from ALD continued to increase, mortality from extrahepatic complications of ALD did not change significantly during the 11-year study. Among patients with nonalcoholic fatty liver disease, the cause of death was most frequently cardiovascular disease, which increased gradually over the study period, whereas liver-related mortality increased rapidly.

CONCLUSIONS:

In an analysis of US Census and the National Center for Health Statistics mortality records, we found that after widespread use of DAA agents for treatment of viral hepatitis, cause-specific mortality from extrahepatic cancers increased, whereas mortality from cardiovascular disease or diabetes increased only among patients with HCV infection. These findings indicate the need to reassess risk and risk factors for extrahepatic cancer, cardiovascular disease, and diabetes in individuals successfully treated for HCV infection with DAA agents.
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Causas de Morte / Hepatite B Crônica / Hepatite C Crônica / Hepatopatia Gordurosa não Alcoólica / Hepatopatias Alcoólicas Tipo de estudo: Estudo de prevalência Limite: Adulto / Idoso / Feminino / Humanos / Masculino / Meia-Idade / Jovem adulto País/Região como assunto: América do Norte Idioma: Inglês Revista: Gastroenterology Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Causas de Morte / Hepatite B Crônica / Hepatite C Crônica / Hepatopatia Gordurosa não Alcoólica / Hepatopatias Alcoólicas Tipo de estudo: Estudo de prevalência Limite: Adulto / Idoso / Feminino / Humanos / Masculino / Meia-Idade / Jovem adulto País/Região como assunto: América do Norte Idioma: Inglês Revista: Gastroenterology Ano de publicação: 2019 Tipo de documento: Artigo