Background Hydrothorax is an independent risk factor for mortality in patients with liver cirrhosis. We aimed to evaluate the secular trend of the disease burden and death of cirrhotic patients with hydrothorax over the last two decades in Hong Kong.

Methods This was a territory-wide cohort study of consecutive patients with liver cirrhosis retrieved from the Clinical Data Analysis and Reporting System (CDARS) from the Hospital Authority from 2000 to 2020. Hydrothorax was defined with the diagnosis codes and retrieved from January 2000 to June 2023.

Results Among the 31,542 patients with liver cirrhosis, 3,251 (10.3%) patients suffered from hydrothorax; their mean age was 58.4±14.2 years; 65.4% were male, mostly due to chronic hepatitis B (68.4%). The mean Child-Pugh score was 7.0±1.4 and the mean Model for End-stage Liver Disease (MELD) score was 13.9±5.2. The disease burden of the first incident hydrothorax increased from 2000 and peaked in 2010, then gradually decreased from 2011-2022 (IDDF2024-ABS-0385 Figure 1. The figure of secular trend and mortality of hydrothorax). There was a delay in the peak of death of these patients, which only peaked in 2015 (183 deaths annually) and decreased to 115-119 deaths annually in 2021-2022 (IDDF2024-ABS-0385 Figure 1. The figure of secular trend and mortality of hydrothorax).

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Abstract IDDF2024-ABS-0385 Figure 1

The figure of secular trend and mortality of hydrothorax

Conclusions The disease burdens of hydrothorax peaked in 2010 whereas the deaths peaked 5 years after that. This is likely related to the improved treatment for the underlying aetiologies of liver cirrhosis, particularly chronic hepatitis B and C. The findings highlight the importance of early treatment for the underlying aetiologies of liver cirrhosis in order to minimize the deaths from this important cirrhotic complication.