Cirrhosis epidemiology and demographics: Difference between revisions

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===Developing Countries===
===Developing Countries===


===Prevalence===
* In 2001, cirrhosis was the tenth leading cause of death for men and the twelfth leading cause for women in the United States.<ref>Anderson RN, Smith BL. Deaths: leading causes for 2001. ''Natl Vital Stat Rep''2003;52:1-85. PMID 14626726.</ref> Also, the cost of cirrhosis in terms of human suffering, hospital costs, and lost productivity is high.
* In 2006, cirrhosis was the twelfth leading cause of deaths in United States.<ref>Heron MP, Hoyert DL, Murphy SL, Xu JQ, Kochanek KD, Tejada-Vera B. Deaths: Final data for 2006. National vital statistics reports; vol 57 no 14. Hyattsville, MD: National Center for Health Statistics. 2009.</ref>
* Established cirrhosis has a 10-year mortality of 34-66%, largely dependent on the cause of the cirrhosis; alcoholic cirrhosis has a worse prognosis than [[primary biliary cirrhosis]] and cirrhosis due to [[hepatitis]]. The risk of death due to all causes is increased twelvefold; if one excludes the direct consequences of the liver disease, there is still a fivefold increased risk of death in all disease categories.<ref>Sorensen HT, Thulstrup AM, Mellemkjar L, Jepsen P, Christensen E, Olsen JH, Vilstrup H. Long-term survival and cause-specific mortality in patients with cirrhosis of the liver: a nationwide cohort study in Denmark. ''J Clin Epidemiol''2003;56:88-93. PMID 12589875.</ref>
* Hospital Inpatient Care: Number of discharges with chronic liver disease or cirrhosis as the first-listed diagnosis: 101,000[http://www.cdc.gov/nchs/fastats/liverdis.htm]
* Mortality due to cirrhosis and chronic liver disease in US: 
** Number of deaths: 30,558
** Deaths per 100,000 population: 10.0[http://www.cdc.gov/nchs/fastats/liverdis.htm]
* '''Alcoholic cirrhosis:'''  Alcoholic cirrhosis develops in 15% of individuals who drink heavily for more than a decade.  There is great variability in the amount of [[alcohol]] needed to cause cirrhosis (as little as 3-4 drinks a day in some men and 2-3 in some women).
* '''Chronic hepatitis B:'''  The [[hepatitis B virus]] is probably the most common cause of cirrhosis worldwide, especially South-East Asia, but it is less common in the United States and the Western world.
* '''Primary biliary cirrhosis:'''  In some areas of the US and UK the prevalence is estimated to be as high as 1 in 4000.
* '''Non alcoholic fatty liver disease:'''  [[Non alcoholic fatty liver disease]], in turn, may progress to [[fibrosis]] and, later, [[cirrhosis]]. Studies of serial [[liver biopsy|liver biopsies]] estimate a 26-37% rate of hepatic fibrosis and 2-15% rate of cirrhosis in less than 6 years. <ref>Adams LA, Sanderson S, Lindor KD, et al. The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies. J Hepatol 2005;42(1):132–8.</ref><ref>Harrison SA, Torgerson S, Hayashi PH. The natural history of nonalcoholic fatty liver disease:a clinical histopathological study. Am J Gastroenterol 2003;98(9):2042–7.</ref><ref>Ekstedt M, Franzén LE, Mathiesen UL, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology 2006;44:865-73.</ref>
* '''[[Alpha 1-antitrypsin deficiency]]''':  Approximately 40 percent of adults with PI*ZZ have histologically significant liver injury and cirrhosis <ref>{{cite journal |author=Bals R |title=Alpha-1-antitrypsin deficiency |journal=Best Pract Res Clin Gastroenterol |volume=24 |issue=5 |pages=629–33 |year=2010 |month=October |pmid=20955965 |doi=10.1016/j.bpg.2010.08.006 |url=}}</ref>
Hepatopulmonary syndrome: has a prevalence of 4-47%.
Portopulmonary hypertension The prevalence is 2% in patients with cirrhosis.
Cirrhotic cardiomyopathy has 50% prevalence in cirrhotic patients.


===Age===
===Age===

Revision as of 16:51, 18 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

The most common cause of cirrhosis in the United States is chronic and heavy alcohol use, while the most common cause of cirrhosis worldwide is the hepatitis virus. Cirrhosis and chronic liver disease is the 12th leading cause of death in United States.

Epidemiology and Demographics

Incidence

  • The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
  • In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.

Prevalence

  • The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
  • In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
  • The prevalence of [disease/malignancy] is estimated to be [number] cases annually.

Case-fatality rate/Mortality rate

  • In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
  • The case-fatality rate/mortality rate of [disease name] is approximately [number range].

Age

  • Patients of all age groups may develop [disease name].
  • The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
  • [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
  • [Chronic disease name] is usually first diagnosed among [age group].
  • [Acute disease name] commonly affects [age group].

Race

  • There is no racial predilection to [disease name].
  • [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].

Gender

  • [Disease name] affects men and women equally.
  • [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.

Region

  • The majority of [disease name] cases are reported in [geographical region].
  • [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

Developed Countries

Developing Countries

Age

  • Cirrhosis is infrequently seen in young adults.

Gender

  • Primary biliary cirrhosis : Primary biliary cirrhosis is more common in women.
  • Chronic Hepatitis C: Among those chronically infected, the risk of cirrhosis after 20 years varies between studies but has been estimated at ~10%-15% for men and ~1-5% for women. The reason for this difference is not known. Once cirrhosis is established, the rate of developing hepatocellular carcinoma is ~1%-4% per year[1]
  • Non alcoholic fatty liver disease: Non-alcoholic fatty liver disease is also more common among men than women in all age groups until age 60, where the prevalence between sex equalize. This is due to the protective nature of estrogen.[2]
  • Autoimmune hepatitis: Autoimmune hepatitis usually occurs in women (70 %) between the ages of 15 and 40.
  • Alpha1 antitrypsin deficiency: Male gender and obesity may be risk factors for progression to advanced liver disease in adulthood among patients with severe AAT deficiency.[3]

Race

  • There is greater prevalence of cirrhosis in hispanics with hepatitis C infection than in caucasian or african american.[3]

References

  1. ↑ Yu ML, Chuang WL (2009). "Treatment of chronic hepatitis C in Asia: when East meets West". J. Gastroenterol. Hepatol. 24 (3): 336–45. doi:10.1111/j.1440-1746.2009.05789.x. PMID 19335784. Unknown parameter |month= ignored (help),
  2. ↑ Lobanova YS, Scherbakov AM, Shatskaya VA, Evteev VA, Krasil’nikov MA (2009). "NF- kappaB suppression provokes the sensitization of hormone-resistant breast cancer cells to estrogen apoptosis". Mol Cell Biochem. 324.
  3. ↑ Bowlus CL, Willner I, Zern MA; et al. (2005). "Factors associated with advanced liver disease in adults with alpha1-antitrypsin deficiency". Clin. Gastroenterol. Hepatol. 3 (4): 390–6. PMID 15822045. Unknown parameter |month= ignored (help)

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