Introduction Alcohol consumption is the third greatest risk factor for global disease, attributing to almost 4% of all deaths worldwide. Alcoholic liver disease (ALD) is one of the major causes of morbidity and mortality associated with long term high alcohol consumption. ALD is an ever increasing problem in England as previous studies have shown. However, little information exists on the trend of emergency admissions and the subsequent in-hospital mortality due to ALD.
Methods We carried out a retrospective analysis of emergency hospital admissions and in-hospital mortality for ALD in all NHS acute care hospitals in England between 2008/2009 and 2011/2012 using National Health Service (NHS) Hospital Episode Statistics (HES) data. We examined the variation in admission and mortality by age, gender and Strategic Health Authority (SHA) in England. HES data are coded using ICD 10 which gives ALD a code of K70.
Results Over the four study year period overall emergency admissions due to ALD increased by 9%; from 17.40 per 100,000 to 18.98 per 100,000 populations. The largest increase in admission was observed for alcoholic hepatic failure with a 44.43% increase. In-hospital mortality from ALD decreased by 9.3% between 2008/09 and 2011/12 from 229.99 deaths to 208.50 deaths per 1,000 ALD emergency admissions. Male mortality was lower than female mortality with male mortality also having a higher decrease of 10.6% compared to 7.3% in females. The rate of mortality differed across age groups peaking in 75–84 year olds, however most age groups saw a decline in mortality rate with 35–44 year olds seeing the greatest decrease of 15.5%. Standardised mortality from ALD also varied by region with the highest mortality found in the West Midlands and on the South East Coast and lowest in London and The North East.
Conclusion ALD related emergency admission rates are still on the increase although not at the same rate as reported in previous studies conducted in the UK. Reduced in-hospital mortality for ALD over the years suggests that hospital care for ALD patients is improving. Continued attention and effort are required to a greater extent to reduce the deaths from ALD.
Disclosure of Interest None Declared.
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