New research revealed today at the UK’s leading liver conference shows that a growing number of patients with chronic liver disease are first diagnosed during an emergency hospital admission in England, and over a third die within a year of their diagnosis.
Chronic liver disease is a major public health issue in the UK, with deaths increasing fivefold since 1970 and it is a leading cause of death in those who are under 65.
The research, being presented at the British Association for the Study of the Liver (BASL) conference in Brighton, used anonymised hospital records to identify people for whom an emergency hospital admission was the first sign that they had chronic liver disease. The researchers found that of 30,000 emergency admissions caused by chronic liver disease a year in England, 13,000 were patients who were diagnosed for the first time. One in six patients (17%) died in hospital, and in total 37% had died within a year of the emergency admission. Of those who left hospital, 34% were readmitted within a month.
Liver disease often develops silently, and most people don’t know that they have it until it reaches an advanced stage, causing sudden health issues that lead to an emergency admission to hospital. People admitted in this way are often very ill, and diagnosis at this advanced stage can often mean it is too late for any effective treatment, which is why so many people sadly die so soon afterwards.
Presenting the early results at the BASL event, Dr Jessica King, assistant professor at the London School of Hygiene & Tropical Medicine, said: “Our analysis of all hospital records from across England allows us to measure the full scale of this problem for the first time. The initial results are stark: the numbers of patients diagnosed in an emergency is increasing, but survival has improved very little. So far, we’ve only looked at the years leading up to the COVID-19 pandemic, and the picture may look even worse with the disruption to health services and increased alcohol use during that time.”
Principal investigator Professor William Bernal from the Institute of Liver Studies, Kings College Hospital, said “These new findings confirm the understanding of clinicians treating people with liver disease. Many present with advanced disease for the first time, and outcomes can be very poor. There is a clear need for early detection, and prevention, of chronic liver disease, as well as better inpatient care. The next steps for our team are to work out what sort of care is linked to the best survival.”
Pamela Healy OBE, Chief Executive of the British Liver Trust, said: “The initial results of this research are very concerning. Liver disease is a silent killer: deaths have more than doubled in the last 20 years and the condition is expected to overtake heart disease as the biggest cause of premature death in the UK in the next few years. Urgent action is needed to ensure that all people with liver disease get access to the best possible care.”
The research comes from a major new NIHR funded project called ‘MAP-CLD: Management of Patients with Chronic Liver Disease admitted to Hospital as an Emergency’, a collaboration between teams at Kings College Hospital, the London School of Hygiene & Tropical Medicine, the University of Exeter and the British Liver Trust.
Dr Rebecca Jones, President of BASL, said, “This research highlights the need for much greater investment in the early detection of liver disease. Early diagnosis can save lives as well as saving money for the NHS.”