Temporal and Demographic Trends in Alcohol-Related-Cirrhosis, Alcohol-Related Hepatitis, and Nonalcohol-Related Cirrhosis Hospitalizations From 2012 to 2023: A Population-Based Study in Alberta, Canada.

INTRODUCTION

Hospitalized patients with cirrhosis or alcohol-related hepatitis (AH) have poor clinical outcomes. We used newly validated case definitions to describe temporal trends in AH, alcohol, and nonalcohol-related cirrhosis (AC, NAC) hospitalization rates between 2012 and 2023 in Alberta, Canada.

METHODS

We selected all adult (≥20 years) AC, NAC, and AH hospitalizations from the 2012-2023 Discharge Abstract Database. Temporal trends in annual age/sex-adjusted hospitalization rates per 100,000 population were assessed using annual percent change and average annual percent change (AAPC) stratified by sex, age, residency (urban/rural), and area-level income quartile.

RESULTS

We identified 25,503 AC, 17,815 NAC, and 2,163 AH hospitalizations. From 2012 to 2023, overall hospitalization rates remained stable for AC (AAPC 0.10%, confidence interval [CI] -0.28 to 0.54) and NAC (AAPC 0.69%, CI -0.42 to 1.88), but increased for AH (AAPC 7.00%, CI 3.79-9.85). AC hospitalization rates increased for people aged 20-34 years (AAPC 16.03%, CI 11.93-21.78) and among the highest area-level income quartile (AAPC 1.84%, CI 1.23-2.51). AH hospitalization rates increased significantly for those aged 20-34 years (AAPC 22.76%, CI 14.82-37.04). During COVID-19, AC and AH hospitalization rates significantly increased, primarily for those in rural areas, and among women and the lowest area-level income quartile for AH. NAC hospitalization rates increased for those 65 years and older (AAPC 2.09%, CI 0.72-3.63), rural men (AAPC 3.12%, CI 0.12-6.50), and rural women (AAPC 4.11%, CI 3.33-4.91).

DISCUSSION: Between 2012 and 2023, we report increasing AH hospitalization rates, and stable AC/NAC hospitalization rates. During COVID-19, AC and AH hospitalization rates increased for those from rural areas and lower income areas for AH.