Table 3.
Early and late mortality following unscheduled admissions for severe liver disease in England and Wales in relation to consultant specialty, hospital size, admissions to liver transplant centres, geographical residential region, season and socio‐demographics
| Early mortality (60‐d follow‐up) | Late mortality (5‐y follow‐up) | |||||||
|---|---|---|---|---|---|---|---|---|
| No. of admissions | Mortality rate (%) | Odds ratio | (95% CI) | No. of admissions | Mortality rate (%) | Odds ratio | (95% CI) | |
| Specialty | ||||||||
| Gastro/ hepatology | 25 978 | 22.4 | Ref | 8892 | 61.2 | Ref | ||
| Other specialties | 47 130 | 26.3 | 1.223 | (1.177, 1.270) | 24 822 | 61.4 | 0.988 | (0.938, 1.041) |
| Hospital size (beds) | ||||||||
| <400 | 11 310 | 25.9 | Ref | 4438 | 62.4 | Ref | ||
| 400‐599 | 22 450 | 25.6 | 1.001 | (0.947, 1.058) | 10 182 | 62.4 | 0.993 | (0.920, 1.071) |
| 600‐799 | 13 381 | 25.0 | 0.996 | (0.937, 1.060) | 5983 | 61.0 | 0.964 | (0.887, 1.048) |
| 800‐999 | 8966 | 21.4 | 0.812 | (0.756, 0.871) | 3652 | 58.2 | 0.874 | (0.796, 0.960) |
| 1000+ | 3485 | 23.4 | 0.884 | (0.804, 0.972) | 1597 | 61.1 | 0.935 | (0.827, 1.057) |
| Admissions to a liver transplant centre | ||||||||
| No | 70 470 | 25.9 | Ref | 32 633 | 61.7 | Ref | ||
| Yes | 2653 | 20.5 | 0.735 | (0.664, 0.814) | 1093 | 50.9 | 0.614 | (0.541, 0.697) |
| Transplant centre admissions | ||||||||
| Local patients | 1524 | 22.7 | Ref | 590 | 55.4 | |||
| Non‐local patients | 1019 | 16.7 | 0.637 | (0.509, 0.796) | 440 | 48.4 | 0.693 | (0.527, 0.912) |
| Liver transplant surgery (during index cohort admission) | ||||||||
| Yes | 140 | 7.9 | Ref | 94 | 20.2 | Ref | ||
| No | 72 983 | 24.9 | 4.037 | (2.151, 7.575) | 33 632 | 61.4 | 7.218 | (4.293, 12.14) |
| Liver transplant surgery | ||||||||
| Local patients | 15 | 0.0 | Ref | 7 | 14.3 | Ref | ||
| Non‐local patients | 125 | 8.8 | * | * | 87 | 20.7 | 0.763 | (0.041, 14.34) |
| Residential region | ||||||||
| London | 9736 | 21.2 | Ref | 4591 | 54.9 | Ref | ||
| South East | 8318 | 26.6 | 1.291 | (1.212, 1.383) | 3867 | 63.5 | 1.335 | (1.218, 1.468) |
| South West | 5908 | 25.5 | 1.221 | (1.144, 1.324) | 2677 | 63.2 | 1.276 | (1.152, 1.414) |
| East of England | 5536 | 24.7 | 1.257 | (1.163, 1.350) | 2614 | 60.8 | 1.213 | (1.094, 1.343) |
| East Midlands | 5006 | 25.7 | 1.284 | (1.199, 1.398) | 2279 | 62.2 | 1.296 | (1.164, 1.443) |
| West Midlands | 7816 | 27.8 | 1.466 | (1.355, 1.549) | 3597 | 62.6 | 1.398 | (1.274, 1.535) |
| Yorkshire & Humber | 7300 | 25.3 | 1.359 | (1.274, 1.462) | 3292 | 61.9 | 1.350 | (1.227, 1.485) |
| North East | 4682 | 24.2 | 1.300 | (1.200, 1.404) | 2140 | 61.0 | 1.324 | (1.187, 1.477) |
| North West | 13 811 | 24.3 | 1.333 | (1.251, 1.409) | 6316 | 62.3 | 1.473 | (1.358, 1.597) |
| Wales | 5010 | 24.0 | 1.236 | (1.152, 1.354) | 2353 | 62.8 | 1.369 | (1.231, 1.522) |
| Season admitted | ||||||||
| Spring | 18 455 | 24.0 | Ref | 8434 | 61.1 | Ref | ||
| Summer | 18 977 | 23.8 | 0.994 | (0.945, 1.045) | 8686 | 60.3 | 0.980 | (0.919, 1.045) |
| Autumn | 18 464 | 25.6 | 1.091 | (1.038, 1.148) | 8280 | 61.9 | 1.040 | (0.975, 1.110) |
| Winter | 17 227 | 26.3 | 1.128 | (1.072, 1.187) | 8326 | 62.0 | 1.029 | (0.964, 1.098) |
| Patient age group | ||||||||
| 18‐35 | 5123 | 10.5 | Ref | 2217 | 35.1 | Ref | ||
| 35‐44 | 14 414 | 15.6 | 1.702 | (1.537, 1.884) | 6945 | 51.0 | 1.922 | (1.738, 2.124) |
| 45‐54 | 21 565 | 21.8 | 2.618 | (2.375, 2.885) | 10 250 | 59.5 | 2.793 | (2.533, 3.079) |
| 55‐64 | 19 101 | 28.6 | 3.838 | (3.480, 4.232) | 8728 | 65.5 | 3.944 | (3.565, 4.363) |
| 65‐74 | 9267 | 36.3 | 5.745 | (5.179, 6.372) | 3988 | 76.9 | 7.003 | (6.215, 7.890) |
| 75+ | 3653 | 51.8 | 10.91 | (9.695, 12.27) | 1598 | 87.6 | 14.26 | (11.97, 16.99) |
| Patient sex | ||||||||
| Male | 47 317 | 24.6 | Ref | 21 904 | 62.2 | Ref | ||
| Female | 25 801 | 25.5 | 1.063 | (1.024, 1.103) | 11 820 | 59.6 | 0.892 | (0.850, 0.936) |
| Social deprivation | ||||||||
| I | 7719 | 27.6 | Ref | 3455 | 62.9 | Ref | ||
| II | 9884 | 27.1 | 1.002 | (0.933, 1.077) | 4481 | 62.6 | 1.016 | (0.923, 1.119) |
| III | 12 270 | 25.5 | 0.997 | (0.931, 1.068) | 5516 | 62.5 | 1.090 | (0.994, 1.195) |
| IV | 16 693 | 24.3 | 1.020 | (0.956, 1.089) | 7745 | 60.8 | 1.085 | (0.995, 1.183) |
| V | 24 889 | 23.7 | 1.092 | (1.026, 1.162) | 11 711 | 61.6 | 1.210 | (1.114, 1.315) |
| Specialty | ||||||||
| Critical care medicine | 749 | 76.1 | Ref | 212 | 89.2 | Ref | ||
| Other specialties | 72 374 | 24.4 | 0.111 | (0.093, 0.133) | 33 514 | 61.2 | 0.197 | (0.127, 0.306) |
Ref = comparison reference category.
*
Denotes zero mortality so that a logistic regression model cannot be applied.