Late diagnosis of chronic liver disease in a community cohort (UK Biobank): determinants and impact on subsequent survival

H. Innes*, J.R. Morling, E.A. Aspinall, D.J. Goldberg, S.J. Hutchinson, I.N. Guha

*Corresponding author for this work

Research output: Contribution to journalArticle

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 in order to support early diagnosis initiatives.METHODS: We identified participants of UK biobank (UKB) study who developed first-time advanced CLD within 5-years. We identified factors associated with late diagnosis via logistic regression, and used survival analysis to measure the association between late CLD diagnosis and mortality risk.RESULTS: 725 UKB participants developed first-time advanced CLD event within 5-years. 83% of cases were diagnosed late. Late diagnosis was associated with aetiology; the odds of late diagnosis were twelve times higher for an individual with alcohol-related liver disease (ArLD) versus 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 post- advanced CLD mortality for patients with NAFLD (aHR:2.18; 95% CI:0.86-5.51; p=0.10), but not for other aetiologies.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 post- advanced CLD mortality may also vary by aetiology.
Original languageEnglish
Number of pages22
JournalPublic Health
Publication statusAccepted/In press - 21 Jul 2020

Keywords

  • cirrhosis; late diagnosis; delayed diagnosis; survival; alcohol-related liver disease; NAFLD; prognosis; chronic liver disease

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