The burgeoning growth in cirrhosis-related hospitalization in Australia, 2008-2016

Background and aims:While chronic liver disease is a major global public health problem, it has not been recognized as a National Health Priority Area in Australia. A population-based study using hospital admission data for cirrhosis in the large state of Queensland, Australia during 2008-2016 was performed.Method:Hospital data on all patient admissions (public and private)and deaths during 2008-2016 in the state of Queensland were obtained. Queensland is a large state in the north-east of Australia with a population of 4.9 million. We identified all hospital admissions for cirrhosis for patients aged 20 years or older. We reported age-standardized hospitalization rates/10, 000 person-years by gender and per calendar year, in-hospital case fatality rate among these admissions (n = 30, 327) and examined the factors associated with hospital deaths. Results:Age-adjusted hospitalization rates increased by 32%between 2008 and 2016, from 8.50/10, 000 (95%CI 8.18-8.82) to11.21/10, 000 (95%CI 10.87-11.54). Admission rates peaked in men at34.03/10, 000 in 55-59 year-olds. The age-standardized admission rate for Indigenous Australians was 32.79/10, 000 (95%CI 31.28-34.31). Alcohol misuse was a contributing factor in over half (55.1%) of all admissions, and in 26.8% of admissions patients resided in most socio-economically disadvantaged areas. The overall in-hospital case fatality rate was 9.7% for males and 9.3% for females, and decreased significantly in males from 10.25% in 2008 to 8.32% in 2016 (p Conclusion:Our data highlights the increasing healthcare use by Australians with cirrhosis and this has major resource and economic implications. Greater awareness and emphasis on preventive care is needed to reduce the increasing prevalence of cirrhosis and the personal, social and economic burden of its complications