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 journalArticlepeer-review

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 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 the factors associated with late diagnosis via logistic regression and used survival analysis to measure the association between late CLD diagnosis and mortality risk. Results: A total of 725 UKB participants developed first-time advanced CLD event within 5 years. In total, 83% of cases were diagnosed late. Late diagnosis was associated with aetiology; the odds of late diagnosis were 12 times higher for an individual with alcohol-related liver disease (ArLD) vs 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 postadvanced CLD mortality for patients with non-alcoholic fatty liver disease (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 postadvanced CLD mortality may also vary by aetiology.
Original languageEnglish
Pages (from-to)165-171
Number of pages7
JournalPublic Health
Volume187
Early online date28 Sep 2020
DOIs
Publication statusPublished - Oct 2020

Keywords

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

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