Shifting cirrhosis phenotype with changes in liver disease etiology in an Australian tertiary hospital

Table 1 Baseline demographics, n (%)/median (interquartile range)

Characteristic	2012 (n = 178)	2019 (n = 198)	P value
Gender			0.4
Male	123 (69)	128 (65)
Female	55 (31)	70 (35)
Age	57 (51, 66)	60 (51, 67)	0.4
Etiology of liver disease			< 0.001
Alcohol	65 (36.5)	95 (48)
Autoimmune	15 (8.4)	12 (6.1)
HBV	14 (7.9)	9 (4.5)
HCV	59 (33.1)	30 (15.2)
NASH	16 (9)	36 (18.2)
Child-Pugh score			0.2
A	7 (3.9)	15 (7.6)
B	74 (41.6)	91 (46)
C	97 (54.5)	92 (46)
MELD score	17 (13, 22)	18 (13, 22)	0.6

HBV: Hepatitis B virus; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis; MELD: Model for end-stage liver disease.

Table 2 Reasons for inpatient hospitalization, n (%)

	2012	2019	P value
Total number of admissions	969	690
Median number of admissions per patient, n (IQR)	2 (1, 4)	2 (1, 3)	0.2
Reason for first presentation of the year			0.4
Ascites/hepatic hydrothorax	72 (40)	75 (38)
Hepatic encephalopathy	48 (27)	54 (27)
Bleeding	25 (14)	36 (18)
Hepatorenal syndrome-acute kidney injury	10 (5.6)	7 (3.5)
Spontaneous bacterial peritonitis	10 (5.6)	5 (2.5)
Other	13 (7.3)	21 (11)
Total number of decompensating liver events	Total n = 1165	Total n = 895
Ascites	760	474
Hepatic hydrothorax	27	29
Hepatic encephalopathy	194	139
Variceal bleeding	47	40
Non-variceal bleeding	35	73
Hepatorenal syndrome-acute kidney injury	51	50
Spontaneous bacterial peritonitis	28	45
Jaundice	23	45

IQR: Interquartile range.

Table 3 Incidence ratio of liver decompensation events in 2012 as compared to 2019

Complication	Incidence rate ratio (IQR)	P value
Ascites	1.80 (1.60, 2.02)	< 0.0001
Hepatic hydrothorax	1.04 (0.59, 1.83)	0.87
Hepatic encephalopathy	1.56 (1.25, 1.96)	< 0.0001
Variceal bleeding	1.32 (0.85, 2.06)	0.2
Non-variceal bleeding	0.54 (0.35, 0.83)	0.003
Hepatorenal syndrome-acute kidney injury	1.14 (0.76, 1.72)	0.5
Spontaneous bacterial peritonitis	0.70 (0.42, 1.14)	0.13
Jaundice	0.57 (0.33, 0.97)	0.03
Other	2.80 (0.45, 29.43)	0.20

IQR: Interquartile range.

Table 4 Episodes of non-variceal bleeding, n (%)

	2012	2019
Patients admitted with a significant non-variceal haemorrhage	23	51
Etiology of liver disease
Alcohol	9 (39.1)	29 (56.9)
Autoimmune	1 (4.3)	2 (3.9)
HBV	2 (8.7)	1 (2)
HCV	6 (26.1)	7 (13.7)
NASH	2 (8.7)	10 (19.6)
Other	3 (13)	2 (3.9)
Antiplatelet or anticoagulation therapy
Yes	1 (4.3)	14 (27.5)
No	22 (95.7)	37 (72.5)
Patients taking antiplatelet/anticoagulant therapy by etiology of liver disease
Alcohol	0	4
Autoimmune	0	0
HBV	0	1
HCV	0	3
NASH	1	6
Other	0	0
Cause of non-variceal bleeding (number of episodes)
GAVE/portal hypertensive gastropathy	24	32
Peptic ulcer	5	11
Other upper gastrointestinal pathology	3	7
Non-upper gastrointestinal bleed	3	23

HBV: Hepatitis B virus; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis; GAVE: Gastric antral vascular ectasia.

Table 5 Etiology of liver disease in patients undergoing liver transplant, n (%)

Etiology	2012 (n = 30)	2019 (n = 24)
Alcohol	4 (13.3)	11 (45.8)
Autoimmune	8 (26.7)	3 (12.5)
HBV	0 (0)	1 (4.2)
HCV	13 (43.3)	2 (8.3)
NASH	3 (10)	4 (16.7)
Other	2 (6.7)	3 (12.5)

HBV: Hepatitis B virus; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis.