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.
|Number of pages||22|
|Publication status||Accepted/In press - 21 Jul 2020|
- cirrhosis; late diagnosis; delayed diagnosis; survival; alcohol-related liver disease; NAFLD; prognosis; chronic liver disease
Innes, H., Morling, J. R., Aspinall, E. A., Goldberg, D. J., Hutchinson, S. J., & Guha, I. N. (Accepted/In press). Late diagnosis of chronic liver disease in a community cohort (UK Biobank): determinants and impact on subsequent survival. Public Health.