| Title: | Late diagnosis of chronic liver disease in a community cohort (UK biobank): determinants and impact on subsequent survival |
| Journal: | Public Health |
| Published: | 28 Sep 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32992162/ |
| DOI: | https://doi.org/10.1016/j.puhe.2020.07.017 |
| URL: | https://nottingham-repository.worktribe.com/preview/4778196/R1%20Manuscript%20AAM.pdf |
Publication 13695
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND: Chronic liver disease (CLD) is frequently diagnosed at a late stage when prognosis is poor. We aimed to determine the patient factors associated with a late CLD diagnosis and its subsequent impact on survival to support early diagnosis initiatives.</p>
METHODS: We identified participants of UK biobank (UKB) study who developed first-time advanced CLD within 5 years. We identified the factors associated with late diagnosis via logistic regression and used survival analysis to measure the association between late CLD diagnosis and mortality risk.</p>
RESULTS: A total of 725 UKB participants developed first-time advanced CLD event within 5 years. In total, 83% of cases were diagnosed late. Late diagnosis was associated with aetiology; the odds of late diagnosis were 12 times higher for an individual with alcohol-related liver disease (ArLD) vs viral hepatitis (aOR:12.01; P < 0.001). Cumulative mortality 5 years after incident advanced CLD was 43.4% (95% CI:39.6-47.0). Late diagnosis was associated with a higher risk of postadvanced CLD mortality for patients with non-alcoholic fatty liver disease (aHR:2.18; 95% CI:0.86-5.51; P = 0.10), but not for other aetiologies.</p>
CONCLUSIONS: Late CLD diagnosis varies according to aetiology and is highest for patients with ArLD and non-alcoholic fatty liver disease. The association between late diagnosis and postadvanced CLD mortality may also vary by aetiology.</p>
14 Keywords
- Adult
- Aged
- Biological Specimen Banks
- Chronic Disease
- Cohort Studies
- Delayed Diagnosis
- Female
- Humans
- Liver Diseases
- Male
- Middle Aged
- Non-alcoholic Fatty Liver Disease
- Survival Analysis
- United Kingdom
6 Authors
- H. Innes
- J.R. Morling
- E.A. Aspinall
- D.J. Goldberg
- S.J. Hutchinson
- I.N. Guha
Enabling scientific discoveries that improve human health