Gastrointestinal disease burden and mortality: A public hospital-based study from 2005 to 2014
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AbstractBackground and Aim
Gastrointestinal (GI) diseases account for substantial morbidity, mortality, and health care utilization. This public hospital‐based study assessed the incidence and time trend of hospitalization and mortality of major GI diseases over one decade.

Methods
We conducted an observational study using population‐wide database managed by the Hong Kong Hospital Authority with a principal diagnosis of GI diseases defined by International Classification of Disease, 9th Revision, Clinical Modification coding. We measured age‐standardized incidence of hospitalization, emergency admissions, multiple admissions, and in‐hospital mortality from 2005 to 2014 using Poisson regression.

Results
The annual incidence of hospitalization for GI diseases increased from 4713 to 5241 per 100 000 discharges (incidence rate ratio [IRR] = 1.004; 95% confidence interval [CI]: 1.003–1.005). GI infections and cancers showed the highest rates of hospitalization in 2014. Hospitalization for GI cancers (IRR = 1.014; 95% CI: 1.013–1.016) and non‐infectious enterocolitis (IRR = 1.058; 95% CI: 1.055–1.061) increased, whereas peptic ulcer disease has decreased. Hospitalization for Crohn's disease showed the most significant rise (126%). Annual incidence of hospitalization for Clostridium difficile infections increased by fivefold (IRR = 1.221; 95% CI: 1.178–1.266), while a 66% reduction was observed for peptic ulcer bleeding (IRR = 0.894; 95% CI: 0.889–0.899). GI cancers had the highest in‐hospital mortality rate in 2014, especially colorectal cancer and gastric cancer.

Conclusions
This study showed an increased hospitalization burden of GI cancers and Crohn's disease, and a reduction in overall mortality for GI diseases. These data provide insight into epidemiological changes of GI diseases in the 21st century and implications for hospital burden and need of resource re‐allocation.
Acceptance Date03/07/2018
All Author(s) ListChan JSH, Chao ACW, Cheung VCH, Wong SSK, Tang W, Wu JCY, Chan HLY, Chan FKL, Sung JJY, Ng SC
Journal nameJournal of Gastroenterology and Hepatology
Year2019
Month1
Volume Number34
Issue Number1
Pages124 - 131
ISSN0815-9319
eISSN1440-1746
LanguagesEnglish-United Kingdom
Keywordsburden, epidemiology, gastrointestinal, Hong Kong

Last updated on 2020-28-06 at 02:17