2 research outputs found
Rising incidence, progression and changing patterns of liver disease in Wales 1999-2019
BACKGROUND
Liver disease incidence and hence demand on hepatology services is increasing.
AIM
To describe trends in incidence and natural history of liver diseases in Wales to
inform effective provision of hepatology services.
METHODS
The registry is populated by International Classification of Diseases-10 (ICD-10)
code diagnoses for residents derived from mortality data and inpatient/day case
activity between 1999-2019. Pseudo-anonymised linkage of: (1) Causative diagnoses; (2) Cirrhosis; (3) Portal hypertension; (4) Decompensation; and (5) Liver
cancer diagnoses enabled tracking liver disease progression.
RESULTS
The population of Wales in 2019 was 3.1 million. Between 1999 and 2019 73054
individuals were diagnosed with a hepatic disorder, including 18633 diagnosed
with cirrhosis, 10965 with liver decompensation and 2316 with hepatocellular
carcinoma (HCC). Over 21 years the incidence of liver diseases increased 3.6 fold,
predominantly driven by a 10 fold increase in non-alcoholic fatty liver disease (NAFLD); the
leading cause of liver disease from 2014. The incidence of cirrhosis, decompensation, HCC, and allcause mortality tripled. Liver-related mortality doubled. Alcohol-related liver disease (ArLD),
autoimmune liver disease and congestive hepatopathy were associated with the highest rates of
decompensation and all-cause mortality.
CONCLUSION
A 10 fold increase in NAFLD incidence is driving a 3.6 fold increase in liver disease in Wales over
21 years. Liver-related morbidity and mortality rose more slowly reflecting the lower progression
rate in NAFLD. Incidence of ArLD remained stable but was associated with the highest rates of
liver-related and all-cause mortality