Management of gallstone disease and chronic liver diseases during the COVID-19 outbreak in Ukraine: an ecological study

Bogomaz, Volodymyr; Natrus, Larysa; Ziuz, Nataliia; Starodub, Tetiana

doi:10.1108/ijhg-09-2023-0087

IJHG

2023

DOI: 10.1108/ijhg-09-2023-0087

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Management of gallstone disease and chronic liver diseases during the COVID-19 outbreak in Ukraine: an ecological study

Volodymyr Bogomaz,

Larysa Natrus,

Nataliia Ziuz

et al.

Abstract: PurposeThe purpose of this paper is to estimate the possible impact of the COVID-19 pandemic on the hospitalization and hospital mortality of the patients with gallstone disease and chronic liver diseases (CLD) in the worst pandemic period in Ukraine.Design/methodology/approachA retrospective comparative analysis of annual reports data of all economy subjects, which conducted economic activity in medical practice for 2019 and 2021. Data was accepted from the Ministry of Health of Ukraine, the National Security… Show more

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2024

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Cited by 2 publications

References 12 publications

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Retrospective study of the frequency of diagnosing diffuse changes in the liver parenchyma according to the results of radiological studies

Ziuz,

Bogomaz

2024

GASTRO

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Background. The prevalence of chronic liver pathology is high and increasing in most countries of the world. Objective: to evaluate the incidence rate of structural diffuse changes in the liver using radiological methods in different sex-age groups of the adult population. Materials and methods. 65,570 unique protocols of ultrasound examination and 1,212 magnetic resonance imaging (MRI) of the hepatobiliary system were studied in patients aged 18 years and older. During the statistical analysis of quantitative features, the distribution of indicators for normality was checked according to the Shapiro-Wilk test. The chi-square test was used to compare frequencies. To determine the relationship between the risk of diffuse liver changes and factor characteristics, we used the method of building logistic regression models. To assess the relationship between the factor traits and the resulting trait, the odds ratio (OR) and 95% confidence interval (CI) were calculated. To assess the quality of the model’s prediction, the area under the curve (AUC) and 95% CI were calculated. The level of statistical significance was chosen at 5 % (p = 0.05). The study was approved by the local ethics committee. Results. The frequency of diagnosing diffuse changes in the liver parenchyma during B-mode ultrasound examination in the total sample was 12.5 % (in women — 8.7 %, in men — 18.2 %). A statistically significant increase (p < 0.01) in the risk of developing diffuse changes in the liver was found (OR = 1.01 (95% CI 1.01–1.02 %) with increasing age for each year. In the univariate logistic regression model, men had a 2.3 times higher chances of developing diffuse liver changes than women (p < 0.01), AUC = 0.604 (95% CI 0.598–0.61 %). In the general sample of patients who underwent MRI of the hepatobiliary system, the frequency of diagnosing fatty infiltration of the liver was 37 % (95% CI 34.3–39.8 %). In particular, among 700 women, the frequency of incidents was 34.1 % (95% CI 30.7–37.7 %), among 512 men — 41.0 % (95% CI 36.8–45.3 %). Conclusions. The prevalence of diffuse liver changes is high (12.5 % according to ultrasound and 37 % according to MRI) and increases with age among the adult population of working age. Given the variety of factors contributing to the progression of chronic liver diseases and the importance of identifying patients at high risk of developing liver cirrhosis, there is a need for widespread implementation of non-invasive diagnostic tests and technical upgrading of specialized healthcare facilities. The data obtained can serve as landmarks for calculating the needs for secondary care and improving clinical pathways for patients.

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Retrospective study of the frequency of diagnosing diffuse changes in the liver parenchyma according to the results of radiological studies

Ziuz,

Bogomaz

2024

GASTRO

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Ultrasound Technologies in Algorithms of Chronic Liver Disease Management

Ziuz,

Bogomaz

2024

Clin. and prev. med.

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Aim. To improve the management algorithm of chronic hepatobiliary pathology by using ultrasound technologies to assess the structure of the liver. Materials and methods. The results of an anonymous electronic survey of 304 doctors using a tailored questionnaire and the authors' own experience of implementing quantitative ultrasound methods of liver assessment at the University Clinic of the Bogomolets National Medical University were analyzed. In accordance with the objective, an analysis of current international guidelines of relevant medical associations was performed. The study of the use of ultrasound diagnostics in the healthcare system of Ukraine was performed using data from open sources of the Ministry of Health of Ukraine and dashboards of the National Health Service of Ukraine (NHSU). Statistical analysis was performed using the MedStat program. The study was approved by the local ethics committee. Results. The availability of basic ultrasound diagnostics of hepatobiliary pathology is high and growing, while modern technologies for quantitative assessment of the liver structure are not sufficiently implemented in medical practice. An improved multilevel patient’s pathway with suspected steatotic liver disease is proposed. Conclusions. Significant limitations of the use of specialized liver examinations in medical practice may adversely affect the quality of medical care. Given the trends in the prevalence of chronic liver disease, the healthcare system needs additional technical equipment for healthcare facilities and focused continuing professional development activities for doctors to ensure the implementation of evidence-based management of chronic hepatobiliary pathology. An improved algorithm of interaction between doctors and the staged use of non-invasive diagnostic tests can help improve the medical care quality and the efficient use of human and financial resources of the healthcare system.

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Management of gallstone disease and chronic liver diseases during the COVID-19 outbreak in Ukraine: an ecological study

Cited by 2 publications

References 12 publications

Retrospective study of the frequency of diagnosing diffuse changes in the liver parenchyma according to the results of radiological studies

Retrospective study of the frequency of diagnosing diffuse changes in the liver parenchyma according to the results of radiological studies

Ultrasound Technologies in Algorithms of Chronic Liver Disease Management

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