Liver disease referrals to an urban, hospital‐based hepatology outpatient clinic over the past 25 years. Issue 3 (5th December 2019)

• Record Type: Journal Article
• Authors: Grubert Van Iderstine, Micah; Iluz‐Freundlich, Daniel; Dolovich, Casandra; Villarin, Eurielle; Minuk, Gerald Y
• Is Part Of: JGH open. Volume 4:Issue 3(2020)
• Page Start: 484
• Page End: 489
• Publication Date: 2019-12-05
• Subjects: alcoholic liver disease -- hepatitis B -- hepatitis C -- hepatology -- liver disease -- non‐alcoholic fatty liver disease -- primary biliary cholangitis -- primary sclerosing cholangitis
• DOI: 10.1002/jgh3.12286
• Languages: English
• ISSNs: 2397-9070

Abstract

Abstract : Background: Additional hepatologists are required to manage the rapidly increasing number of patients with liver disease. One disincentive to trainees considering a career in hepatology is the longstanding perception that outpatient hepatology consists largely of managing patients with alcohol‐induced liver disease (ALD). Objectives: To document the types of liver diseases and changes in liver disease referrals to an urban outpatient liver disease clinic over the past 25 years. Methods: The nature of the liver disorder, age, gender, and socioeconomic status of patients referred to an urban, hospital‐based, liver diseases outpatient program were documented from 1992 to 2017. Joinpoint analysis was performed to identify significant trends in referral prevalence rates of various disorders. Results: In 1992/1993, hepatitis C virus (HCV), followed by hepatitis B virus (HBV), "other", non‐alcoholic fatty liver disease (NAFLD), and primary biliary cholangitis (PBC) were the most common underlying liver diseases in referred patients (39, 36, 12, 4.5, and 3.5% respectively), whereas in 2016/2017, NAFLD, HBV, HCV, "other, " and ALD were most common (60, 15, 12, 8.7, and 3.3%, respectively). Aside from NAFLD referrals, which consistently increased over the 25‐year period, the prevalence of all other liver disease referrals fluctuated but generally declined. Recently referred patients were significantly older (38 ± 13 years in 1992/1993 and 49 ± 15 years in 2016/2017, P < 0.0001), while gender and socioeconomic status have not changed. Conclusions: Hepatology is a diverse, dynamic subspecialty where ALD continues to constitute less than 5% of all patient referrals. Abstract : Outpatient hepatology consists of a variety of liver disorders. Over the past 25 years, the prevalence of these disorders has significantly changed. Such information is very useful for trainees considering a career in hepatology.