Cirrhosis Due to Alcohol-Related Liver Disease Hospitalizations in Belgrade, Serbia: A 10-Year Retrospective

Tamara  Milovanovic; Sofija  Lugonja; Ivana  Pantic; Svetlana  Miltenovic; Zeljko Vlaisavljevic; Abbas  Mardani

doi:10.18502/ijph.v51i10.10985

Tamara Milovanovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Sofija Lugonja General Hospital “DjordjeJoanovic”, Department of Internal Medicine, Division of gastroenterology, Zrenjanin, Serbia
Ivana Pantic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, Belgrade, Serbia
Svetlana Miltenovic Institute of Public Health of Belgrade, Belgrade, Serbia
Zeljko Vlaisavljevic Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, Belgrade, Serbia
Abbas Mardani Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v51i10.10985

Keywords: Alcohol-related liver disease; Cirrhosis; Hospitalization; Public health

Abstract

Background: Cirrhosis due to alcohol-related liver disease (ALD cirrhosis) is a significant burden to health systems worldwide. We aimed to determine the trends in hospitalization frequency due to ALD cirrhosis and to analyze their characteristics.

Methods: This cross-sectional study used data from the Institute of Public Health of Belgrade database, and included all hospitalization reports which contained code K70.3 (Cirrhosis hepatis alcoholica) as the primary diagnosis, including re-hospitalizations, on the territory of Belgrade, between January 2009 and December 2018.

Results: A total of 4644 patients with ALD cirrhosis were hospitalized (male: 4154, 89.45%), with a mean age of 58.83±10.02 years. During the 2009-2018 decade, no difference in the number of ALD cirrhosis hospitalizations in subsequent years was observed. Men more commonly developed esophageal and gastric varices with bleeding compared to women (P=0.037), while women developed acute-on-chronic liver failure (ACLF) almost two-times more often compared to men (P<0.001). Patients with hepatocellular carcinoma were significantly older (P<0.001), while those who developed ascites and splenomegaly were significantly younger compared to those who did not (P<0.001 and P=0.04, respectively). Altogether, complications of portal hypertension were registered and reported with very low frequency, and therefore do not represent actual frequencies of these conditions. The median duration of hospital stay was 9 days (range 0-243). Patients in whom lethal outcome occurred during the hospitalization were significantly older, and more commonly developed chronic renal failure.

Conclusion: These data offer an important insight into the ALD cirrhosis-related hospitalizations while drawing attention to inadequate coding as an important public health issue at the same time.