Liver disease death risk more than doubles in low-income countries: Lancet study

The risk of death for hospitalized liver disease patients in low- or lower-middle-income countries is more than twice as high as in high-income countries, according to a study that analyzed data from 25 countries, including India. The study, published in the journal Lancet Gastroenterology & Hepatology, found that the higher risk in low-income countries is mainly due to limited access to diagnostic and therapeutic resources.

Liver disease occurs when a person’s liver experiences chronic inflammation, often due to obesity, excessive alcohol use, viral hepatitis, or a combination. Over time, this inflammation can cause severe scarring of the liver, known as cirrhosis, that impairs liver function and can eventually lead to liver failure.

Liver disease is one of the leading causes of death in the world, currently killing 2 million people every year, and is expected to kill even more people in the future, according to researchers.

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“Liver functioning is very important for our health as the organ is involved in many aspects of bodily functions,” said Professor Jasmohan Bajaj from Virginia Commonwealth University School of Medicine, US. “Anything that affects the liver can affect other organs and systems in our bodies, including our immune system, cardiovascular system, brain, intestines and kidneys,” Bajaj said.

Bajaj and Ashok K Choudhary, a professor at the Institute for Liver and Biliary Sciences in New Delhi, and colleagues examined how the risk of death from cirrhosis varies across countries and the underlying factors behind such disparities.

“Most cirrhosis research has focused on the global north or specific regions of the world and has not accounted for differences in public health resources. Our work is one of the only prospective studies to analyze the imbalance in cirrhosis mortality from a global perspective.” Bajaj, lead author of the study.

The research team collected and analyzed medical data from nearly 4,000 patients with cirrhosis at 90 medical centers in 25 countries on six continents. Cirrhosis patients in low-income countries were twice as likely to die in hospital or within 30 days of discharge, compared to patients treated in high-income countries, according to the data.

Bajaj said, “These results are very shocking and sobering. We did not expect such a wide disparity in cirrhosis mortality, but it shows that globally we are at a similar level in terms of addressing advanced liver disease. are not.”

The study also highlights global differences in medical resources that may contribute to variation in mortality rates.

For example, survey data showed that patients with cirrhosis in low-income countries were less likely to have access to or afford relevant diagnostics, drugs, therapy, ICU care and liver transplants during hospitalisation.

Cirrhosis patients in low-income countries were more likely to be hospitalized in later stages of the disease and more likely to have gastrointestinal bleeding, hepatitis B flare or infection, all preventable provided with appropriate care. conditions, the researchers said.

They said the findings may reflect a lack of outpatient care for patients as well as personal financial resources.

“Importantly, patient care for cirrhosis should begin well before hospitalisation. Recognition, access and affordability of treatment are three important factors that would ideally prevent a lot of hospitalisations,” Bajaj said. couple.