Table 1.
Hospital admissions reported across included studies
| Study | Country | Population | N | Outcome | Hospital admissions |
|---|---|---|---|---|---|
| LT-related hospitalisations | |||||
| Aby et al. [21] | US | LT recipients with NASH cirrhosis or cryptogenic cirrhosis, 2002–2015 | 1-year post-transplant hospital admissions, median (IQR) |
Sarcopenia vs no sarcopenia: 1 (0.2–2) vs 1 (0–2); p = 0.402 |
|
| With sarcopenia | 90 | ||||
| Wthout sarcopenia | 56 | ||||
| Agopian et al. [22] | US | Patients who underwent primary LT, 1993–2011 | NASH as primary indication for LT, % | 2002 vs 2011: 3 vs 19 | |
| NASH aetiology | 144 | ||||
| Non-NASH aetiology | 1150 | ||||
| HBV | 691 | ||||
| HCV | 127 | ||||
| ALD | 185 | ||||
| CC | 58 | ||||
| PBC/PSC | 89 | Pre-transplant hospitalisations, % |
NASH vs non-NASH: 62 vs 41 HCV: 37; HBV: 25; ALD: 60; CC: 67; PBC/PSC: 43 |
||
| Barbas et al. [23] | Canada | NASH patients undergoing primary LT, 2000–2014 | Pre-transplant hospitalisations, % | LDLT vs DDLT: | |
| LDLT | 48 | Home/hospital | 69.6/30.4 vs 50.8/49.2; p = 0.03 | ||
| DDLT | 128 | Home/ward/ICU | 69.6/28.3/2.2 vs 50.8/39.2/10.0; p = 0.06 | ||
| Morris et al. [24] | US | Patients who underwent LSG following LT, 2014–2018 | 15 | Post-transplant LSG ICU admissions, n (%) | 1 (6.7) |
| NASH | 14 | ||||
| Cirrhosis-related hospitalisations | |||||
| Axley et al. [27] | US | Hospital admissions for cirrhosis (2006–2014) | 1,928,764 | Proportion of cirrhosis admissions with NASH aetiology, % | 2006–8 vs 2012–14: 6 vs 12; p < 0.001 |
| NASH-related | 179,104 | NASH-related admissions: | |||
| Proportion of NASH cirrhosis hospitalisations that developed ACLF, n (%) | 2006–14: 8903 (5) | ||||
| ACLF admissions in NASH cirrhosis patients, % | 2006–8 vs 2012–14: 3.5 vs 5.7; p < 0.001 | ||||
| Frequency of ACLF admissions for NASH (proportion of total ACLF admissions in NASH cirrhosis patients), % | 2006–8/2009–11/2012–14: 12/33/55 | ||||
| CC subgroup with discharge diagnosis of NASH | 699,668 | CC subgroup: | |||
| Proportion of CC admissions with discharge diagnosis of NASH, % | 2006–8 vs 2012–14: 49 vs 54; p NR | ||||
| ACLF admissions with NASH cirrhosis, % | 2006–8 vs 2012–14: 4.5 vs 6.2; p < 0.001 | ||||
| Frequency of ACLF admissions in NASH cirrhosis (proportion of total ACLF admissions with NASH cirrhosis), % | 2006–8/2009–11/2012–14: 23/NR/43 | ||||
| Hospitalisation rates in NASH patients alone or versus general population and/or patients with T2D | |||||
| Balp et al. [26] | EU5a | Respondents to the National Health and Wellness Survey | Hospitalisations in past 6 months, mean |
NASH vs general population: 0.47 vs 0.17; p < 0.001 NASH vs T2D: 0.39 vs 0.19; p = 0.033 |
|
| NASH | 184 | ||||
| Unmatched general population | 79.267 | ||||
| Unmatched T2D | 4783 | ||||
| Carruthers et al. [28] | England | Patients with biopsy-proven NASH and diabetes (inpatient and day-case admissions to NHS hospitals 2004–2015) | 2004/05: 1303 | Number of admissions | 2004–5 vs 2014–15: 1303 vs 2341 |
| 2014/15: 2341 | Hospital admission rates from 2004–2014 (rate per 100,000 population) |
Overall: 2004: 73.8; 2005: 76.8; 2006: 73.4; 2007: 71.4; 2008: 71.9; 2009: 75.6; 2010: 79.2; 2011: 79.7; 2012: 83.5; 2013: 78; 2014: 80.4 Rate ratio: 1.01 (1.00–1.02); p = 0.04 Male: 2004: 41.5; 2005: 44; 2006: 43.9; 2007: 42.6; 2008: 43.8; 2009: 43.7; 2010: 47.9; 2011: 46.5; 2012: 48.2; 2013: 45; 2014: 47.6 Rate ratio: 1.01 (1.00–1.02); p = 0.03 Female: 2004: 32.2; 2005: 32.8; 2006: 29.5; 2007: 28.8; 2008: 28.1; 2009: 31.9; 2010: 31.3; 2011: 33.2; 2012: 35.3; 2013: 33; 2014: 32.8 Rate ratio: 1.00 (0.99–1.02); p = 0.37 17–44 years: 2004: 7.5; 2005: 8.2; 2006: 7.3; 2007: 7.5; 2008: 6.3; 2009: 7.4; 2010: 8.3; 2011: 7.3; 2012: 10.7; 2013: 7.5; 2014: 7.2 Rate ratio: 1.01 (0.98–1.03); p = 0.54 44–64 years: 2004: 33.7; 2005: 37.1; 2006: 33.6; 2007: 30.9; 2008: 33.3; 2009: 30; 2010: 31.8; 2011: 31.8; 2012: 30.9; 2013: 32.8; 2014: 29.7 Rate ratio: 0.99 (0.97–0.99); p = 0.002 65+ years: 2004: 32.5; 2005: 31.5; 2006: 32.5; 2007: 33; 2008: 32.3; 2009: 38.2; 2010: 39.1; 2011: 40.6; 2012: 41.8; 2013: 37.7; 2014: 43.5 Rate ratio: 1.03 (1.02–1.04); p < 0.001 |
|||
| Carruthers et al. [28] | England | Patients with biopsy-proven NASH without diabetes (inpatient and day-case admissions to NHS hospitals 2004–2015) | 2004/05: 12,758 | Number of admissions | 2004–5 vs 2014–15: 12,758 vs 10,988 |
| 2014/15: 10,988 | Hospital admission rates from 2004–2014 (rate per 100,000 population) |
Overall: 2004: 33.6; 2005: 35.7; 2006: 34.7; 2007: 33.5; 2008: 32.6; 2009: 31.3; 2010: 31.4; 2011: 30.7; 2012: 30.1; 2013: 28.3; 2014: 21.7 Rate ratio: 0.97 (0.96–0.98); p < 0.001 Male: 2004: 18.9; 2005: 20.1; 2006: 19.4; 2007: 18.3; 2008: 17.6; 2009: 17.3; 2010: 17.3; 2011: 16.2; 2012: 15.8; 2013: 14.3; 2014: 11 Rate ratio: 0.96 (0.95–0.97); p < 0.001 Female: 2004: 14.7; 2005: 15.6; 2006: 15.3; 2007: 15.2; 2008: 15; 2009: 14; 2010: 14.1; 2011: 14.5; 2012: 14.3; 2013: 14; 2014: 10.7 Rate ratio: 0.98 (0.97–0.99); p < 0.001 17–44 years: 2004: 10.5; 2005: 11.1; 2006: 10.7; 2007: 9.4; 2008: 9.1; 2009: 8.8; 2010: 8.5; 2011: 8.5; 2012: 8.3; 2013: 7.3; 2014: 5.4 Rate ratio: 0.95 (0.94–0.96); p < 0.001 44–64 years: 2004: 14; 2005: 15.1; 2006: 14.5; 2007: 14.3; 2008: 13.7; 2009: 12.6; 2010: 12.9; 2011: 12.5; 2012: 12.1; 2013: 10.9; 2014: 8.5 Rate ratio: 0.96 (0.95–0.97); p < 0.001 65+ years: 2004: 9.1; 2005: 9.5; 2006: 9.5; 2007: 9.8; 2008: 9.8; 2009: 9.9; 2010: 10; 2011: 9.7; 2012: 9.7; 2013: 10.1; 2014: 7.8 Rate ratio: 1.00 (0.99–1.00); p = 0.45 |
|||
| Geier et al. [29] | US, France, Germany | NASH patients (NASH-Atlas program July–November 2017) | Number of inpatient visits, mean (SD) |
Total population: 0.3 (3.9) BC vs phenotypic NASH: 0.3 (NR) vs 0.3 (NR) FR vs DE vs US: 0.5 (NR) vs 0.5 (NR) vs 0.1 (NR) |
|
| Total | 1216 | ||||
| BC NASH | 786 | ||||
| Phenotypic NASH | 430 | ||||
| French NASH population | 227 | ||||
| German NASH population | 287 | ||||
| US NASH population | 702 | ||||
aEU5 includes France, Germany, Italy, Spain and the UK
ACLF acute-on-chronic liver failure, ALD alcoholic liver disease, BC biopsy-confirmed, CC compensated cirrhosis, CI confidence interval, DDLT deceased donor liver transplant, DE German cohort, FR French cohort, HBV hepatitis B virus, HCV hepatitis C virus, ICU intensive care unit, IQR interquartile range, LDLT living donor liver transplantation, LSG laparoscopic sleeve gastrectomy, LT liver transplantation, NASH non-alcoholic steatohepatitis, NASH-Atlas Growth from Knowledge (currently Ipsos) Disease Atlas Real-World Evidence program, NHS National Health Service, NR not reported, PBC primary biliary cirrhosis, PSC primary sclerosing cholangitis, SD standard deviation, T2D type 2 diabetes, US US cohort