Increasing Health Care Burden of Chronic Liver Disease Compared With Other Chronic Diseases, 2004–2013

Asrani, Sumeet K.; Kouznetsova, Maria; Ogola, Gerald; Taylor, Thomas J.; Masica, Andrew L.; Pope, Brandon; Trotter, James F.; Kamath, Patrick S.; Kanwal, Fasiha

doi:10.1053/j.gastro.2018.05.032

Cited by 97 publications

(93 citation statements)

References 36 publications

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“…Thus, it seems undeniable that chronic HCV infection boosts the cardiovascular disease burden among the affected patients. The role of co-morbidities is of utmost importance, as it was recently observed in a US population-based study [7]. It would be interesting if Piekarska et al could provide us with the patients' co-morbidities, mainly diabetes mellitus, chronic kidney disease, hypertension and obesity, as they might have an impact on their results [1].…”

Section: Dear Editormentioning

confidence: 97%

Hepatitis C virus infection and atherosclerotic cardiovascular disease: recent knowledge, further insights

Patoulias

Kalogirou

2020

ceh

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Section: Dear Editormentioning

confidence: 97%

Hepatitis C virus infection and atherosclerotic cardiovascular disease: recent knowledge, further insights

Patoulias

Kalogirou

2020

ceh

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“…C irrhosis is increasingly common and morbid. Since the 2000s, its U.S. prevalence has risen by 50%, (1) cirrhosis-related hospitalizations have increased by 90%, (2) and its mortality has risen by 65%. (3) Cirrhosis is associated with a substantial symptom burden that diminishes the patient's healthrelated quality of life (HRQOL) and causes disability, which in turn affects the HRQOL and productivity of their caregivers.…”

mentioning

confidence: 99%

Comprehensive Health‐State Utilities in Contemporary Patients With Cirrhosis

et al. 2020

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Cost-effectiveness analysis depends on generalizable health-state utilities. Unfortunately, the available utilities for cirrhosis are dated, may not reflect contemporary patients, and do not capture the impact of cirrhosis symptoms. We aimed to determine health-state utilities for cirrhosis, using both the standard gamble (SG) and visual analog scale (VAS). We prospectively enrolled 305 patients. Disease severity (Child-Pugh [Child] class, Model for End-Stage Liver Disease with sodium [MELD-Na] scores), symptom burden (sleep quality, cramps, falls, pruritus), and disability (activities of daily living) were assessed. Multivariable models were constructed to determine independent clinical associations with utility values. The mean age was 57 ± 13 years, 54% were men, 30% had nonalcoholic steatohepatitis, 26% had alcohol-related cirrhosis, 49% were Child class A, and the median MELD-Na score was 12 (interquartile range [IQR], 8-18). VAS displayed a normal distribution with a wider range than SG. The Child-specific SG-derived utilities had a median value of 0.85 (IQR, 0.68-0.98) for Child A, 0.78 (IQR, 0.58-0.93) for Child B, and 0.78 (IQR, 0.58-0.93) for Child C. VAS-derived utilities had a median value of 0.70 (IQR, 0.60-0.85) for Child A, 0.61 (IQR, 0.50-0.75) for Child B, and 0.55 (IQR, 0.40-0.70) for Child C. VAS and SG were weakly correlated (Spearman's rank correlation coefficient, 0.12; 95% confidence interval, 0.006-0.23). In multivariable models, disability, muscle cramps, and MELD-Na were significantly associated with SG utilities. More clinical covariates were significantly associated with the VAS utilities, including poor sleep, MELD-Na, disability, falls, cramps, and ascites. Conclusion: We provide health-state utilities for contemporary patients with cirrhosis as well as estimates of the independent impact of specific symptoms on each patient's reported utility. (Hepatology Communications 2020;4:852-858). Abbreviations: ADL, activities of daily living; Child, Child-Pugh; CI, confidence interval; HE, hepatic encephalopathy; HRQOL, health-related quality of life; IQR, interquartile range; MELD-Na, Model for End-Stage Liver Disease with sodium; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; rs, Spearman's rank correlation coefficient; SG, standard gamble; VAS, visual analog scale.

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“…The burden of chronic liver disease in the United States is likely underestimated . Studies have demonstrated increasing complications of hepatitis C cirrhosis, increasing prevalence of nonalcoholic fatty liver disease, and the rising incidence of liver cancer . Nonalcoholic fatty liver disease has an estimated prevalence of approximately 20%‐35% in the United States and is expected to increase commensurate with the current obesity epidemic .…”

mentioning

confidence: 99%

Electronic Consultations to Hepatologists Reduce Wait Time for Visits, Improve Communication, and Result in Cost Savings

et al. 2019

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Increasing Health Care Burden of Chronic Liver Disease Compared With Other Chronic Diseases, 2004–2013

Cited by 97 publications

References 36 publications

Hepatitis C virus infection and atherosclerotic cardiovascular disease: recent knowledge, further insights

Hepatitis C virus infection and atherosclerotic cardiovascular disease: recent knowledge, further insights

Comprehensive Health‐State Utilities in Contemporary Patients With Cirrhosis

Electronic Consultations to Hepatologists Reduce Wait Time for Visits, Improve Communication, and Result in Cost Savings

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