A stable cohort (n = 369,725) was reconstructed to test the association of hepatitis B virus (HBV) infection with subsequent occurrence of liver cancer in a healthy Korean population. The cohort consisted of male beneficiaries of the Korea Medical Insurance Corporation over 30 years of age, living nationwide. The HBV infection was tested by the reversed passive hemagglutination method for the HBsAg and by the passive hemagglutination method for the anti-HBs at the time of recruitment in 1984. Admissions due to liver diseases were identified through a computerized system for reimbursements on medical insurance claims from January 1, 1985 to December 31, 1987. For a more valid estimate of incidence, a sample survey was carried out, obtaining correction coefficients against misclassification of the diagnosis, as well as those for duplicate claims in a year. The incidence rate of liver cancer steadily increased with age (kappa 2 TREND = 51.1, df = 1, p = 0.00).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult ; Age Factors ; Aged ; Cohort Studies ; Hepatitis B/*complications ; Humans ; Incidence ; Income ; Korea/epidemiology ; Liver Neoplasms/epidemiology/*microbiology ; Male ; Middle Aged ; Risk Factors

BACKGROUND/AIMS: Data on the epidemiology of alcoholic cirrhosis, especially in Asian countries, are limited. We compared the temporal evolution of patterns of alcoholic and nonalcoholic cirrhosis over the last decade. METHODS: We retrospectively examined the inpatient datasets of five referral centers during 2002 and 2011. The study included patients who were admitted due to specific complications of liver cirrhosis. We compared the causes of hospital admissions and in-hospital deaths between patients with alcoholic and nonalcoholic cirrhosis. RESULTS: Among the included 2,799 hospitalizations (2,165 patients), 1,496 (1,143 patients) were from 2002, and 1,303 (1,022 patients) were from 2011. Over time, there was a reduction in the rate of hepatic encephalopathy (HE) as a cause of hospitalization and an increase in the rate of hepatocellular carcinoma. Deaths that were attributable to HE or spontaneous bacterial peritonitis (SBP) significantly decreased, whereas those due to hepatorenal syndrome (HRS) significantly increased over time in patients with alcoholic cirrhosis. However, in patients with nonalcoholic cirrhosis, hepatic failure and HRS remained the principal causes of in-hospital death during both time periods. CONCLUSIONS: The major causes of in-hospital deaths have evolved from acute cirrhotic complications, including HE or SBP to HRS in alcoholic cirrhosis, whereas those have remained unchanged in nonalcoholic cirrhosis during the last decade.
Aged ; Asia/epidemiology ; Bacterial Infections/etiology/mortality ; Carcinoma, Hepatocellular/etiology/mortality ; Cause of Death ; Female ; Hepatic Encephalopathy/etiology/mortality ; Hepatorenal Syndrome/etiology/mortality ; Hospital Mortality/*trends ; Hospitalization/*trends ; Humans ; Liver Cirrhosis/*complications/mortality ; Liver Cirrhosis, Alcoholic/*complications/mortality ; Liver Neoplasms/etiology/mortality ; Male ; Middle Aged ; Peritonitis/microbiology/mortality ; Retrospective Studies ; Risk Factors ; Time Factors