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Alcoholic liver disease (ALD)-related hospital admissions in Ireland increased by 23 per cent over ten years, while hepatocellular carcinoma (HCC)-related admissions increased by 300 per cent in the same period, new research presented at the Irish Society of Gastroenterology (ISG) 2018 Annual Winter Meeting shows.
The study, presented by researchers from the National Liver Transplant Unit in St Vincent’s University Hospital, Dublin, examined data on hospital inpatients with ALD admitted between 2006-2016 in all acute public hospitals across Ireland, using HSE HiPE data.
In total, during the ten-year period, 3,532 discharges with ALD were recorded, with an average length of stay of 13 days.
Of these patients, 57 per cent had cirrhosis, 27 per cent had ascites and 10 per cent had acute kidney failure.
Overall mortality was 9 per cent, but rose to 15 per cent if ascites was present and 37 per cent if acute kidney failure was present. Only 30 per cent of these patients were under a gastroenterologist at discharge.
In 2016 alone, 40,482 public hospital bed days were utilised by patients with ALD.
“This unfortunately is the tip of the iceberg and does not include emergency department or clinic attendances. These patients were sick, the majority having cirrhosis and other complications such as ascites or variceal bleeding; one in 10 died,” study co-author Prof Ross McNicholas, Consultant Gastroenterologist with a special interest in liver disease, told the Medical Independent (MI).
He said the burden of liver disease in Ireland is largely unknown and there is no clinical programme to address it. “The UK has seen a 400 per cent increase in liver mortality rates since 1970 in contrast to a steady decline in rates from most other chronic diseases.”
There needs to be a co-ordinated national approach to liver disease with all patients being offered access to specialist liver units, Prof McNicholas maintained.
“This is a public health issue, the passing of the Alcohol Bill and introduction of minimum pricing will hopefully produce results down the line. In the meantime prompt access to brief interventions and alcohol specialist nurses should be available in all public hospitals and communities.”
The ISG Annual Winter Meeting is taking place in Killiney, Co Dublin, from 21-23 November, and exclusive, comprehensive coverage will be included in the December20 issue of MI.
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