Chronic liver disease on rise in Queensland

A new study by QIMR Berghofer and Princess Alexandra Hospital has found a significant increase in the number of Queenslanders being admitted to hospital for treatment of chronic liver disease, and the rates are highest among the state’s most disadvantaged.

The results of the nine-year study have been published today in the journal EClinical Medicine.

The researchers examined Queensland Health admissions data from 2008 to 2016, from all public and private hospitals.

Senior author, Associate Professor Patricia Valery, from QIMR Berghofer’s Cancer and Chronic Disease research group said in that period, there was a 62 per cent increase in the number of patients being treated for cirrhosis at Queensland hospitals, from 2,701 admissions in 2008 to 4,367 in 2016.

“Hospitalisation rates for cirrhosis increased from 8.5 per 10,000 people to 11 per 10,000, and were highest among men aged 55 to 59 and in Indigenous Australians,” Associate Professor Valery said.

“The rate of admission with cirrhosis was three times higher for Indigenous patients than the rest of the population.

“The overall deaths from cirrhosis-related admissions to hospitals was 9.7 per cent for males and 9.3 per cent for females.”

Lead researcher and Princess Alexandra Hospital Hepatologist, Professor Elizabeth Powell, said the study found alcohol misuse was a contributing factor in 55 per cent of cirrhosis admissions, and socioeconomic disadvantage was a contributing factor in 27 per cent of cases.

“About one in four of all cirrhosis admissions to Queensland hospitals were from patients residing in the most socioeconomically disadvantaged areas of the state, compared to one in five for all hospital admissions in Australia,” Professor Powell said.

“The number of Indigenous hospital patients with cirrhosis increased from 201 in 2008 to 341 in 2016.

“The percentage increase in the number of cases varied by socioeconomic disadvantage too, with a three per cent increase in admissions among those classified as most affluent, while there was a 9.5 per cent increase among the state’s lowest earners and unemployed.

“It’s a serious disease and patient care in advanced cirrhosis is challenging. Many patients are on multiple medications, have dietary restrictions, and may require repeated hospital admissions each year.

“Many patients admitted to hospital with serious complications of cirrhosis, such as severe jaundice and confusion, may not live for more than two years without a liver transplant.

“There are many triggers for the disease, including excessive alcohol use, hepatitis, or if people have fatty liver disease, which is usually a consequence of obesity.”

Associate Professor Valery said the study findings had implications for Queenslanders and health care providers.

“We need to better plan for the increasing number of cases we will see in the future,” she said.

“We will need more hospital beds and health services for patients with chronic liver disease. Importantly, we need more resources for front line health providers such as GPs, so they can identify patients early and avoid progression to advanced cirrhosis.

“The disproportionate impact of cirrhosis on disadvantaged Australians and Indigenous Australians also highlights the need for better targeted public health messages about alcohol consumption, maintaining a healthy weight and the need for Hepatitis immunisations.”

Queensland man Steve, 59, has been managing his cirrhosis since he was diagnosed with the disease when he turned 50, and believes early screening helped save his life.

“It was picked up when doctors screened my liver in 2010 when treating me for Hepatitis C,” Steve said.

“I’m not sure how I contracted Hepatitis C. It may have been the result of the way I partied as a young adult in the 1970s or when I had surgery in my 20s, but it led to cirrhosis.

“They discovered I had a tumour on my liver, which was the result of cirrhosis, but because it was caught early the cancer was taken out and I have made a full recovery.

“So many people I know, around my age, have cirrhosis or have died from liver cancer.

“The worst thing about chronic liver disease is that it is a silent killer! You can develop tumours and not know, and that’s why it’s so important to have a good GP who will keep an eye out for cirrhosis and get their patients tested.

“People around my age and younger should also ask their GPs if they think they should be tested for liver disease. It’s better to find out you’ve dodged a bullet or get treated early than find out too late.”

Associate Professor Valery said there was a need to replicate the studies of hospital admissions for cirrhosis in other states.

The team plans to do more research into chronic liver disease in Indigenous communities.

The research was partially funded by the NHMRC and Brisbane Diamantina Health Partners.

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