Epidemiology of Alcohol-Related Hepatitis, Alcohol-Related Cirrhosis, and Non-Alcohol-Related Cirrhosis in Alberta, Canada: An Administrative Data Validation and Population-Based Study

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dc.contributor.advisorShaheen, Abdel-Aziz
dc.contributor.advisorGodley, Jenny
dc.contributor.authorSwain, Liam Andrew
dc.contributor.committeememberMcLaren, Lindsay
dc.contributor.committeememberTang, Karen
dc.contributor.committeememberBrenner, Darren
dc.date2024-11
dc.date.accessioned2024-08-01T15:06:27Z
dc.date.available2024-08-01T15:06:27Z
dc.date.issued2024-07-22
dc.description.abstractBackground: Population-based studies evaluating the epidemiology of chronic liver diseases rely on accurate case definitions. This thesis aimed to develop new coding algorithms for alcohol- (AC) and non-alcohol-related cirrhosis (NAC) to use alongside a previously validated alcohol-related hepatitis (AH) coding algorithm to examine population-level AC, NAC, and AH hospitalization rate trends from 2012-2022, in Alberta, Canada. Methods: Using a randomly selected cohort of 700 admissions with diagnostic codes for alcohol- and cirrhosis-related conditions from the 2008-2022 Calgary Discharge Abstract Database (DAD), we validated (using electronic medical record review) newly developed and commonly used AC/NAC case definitions. The newly validated coding algorithms were used to select all adult AC/NAC/AH hospitalizations in the Alberta DAD from 2012-2022. All admissions were postal code matched to the 2016 Alberta Census data aggregated to the DA level. Temporal trends in annual sex/age-standardized hospitalization rates per 100,000 Alberta population were examined using Joinpoint analysis stratified by sex, age, area-level income quartile, and rural/urban residency. Results: Our new AC algorithm selecting codes for AC, alcohol-related hepatic failure, or alcohol use disorder (AUD) with a decompensated cirrhosis condition or NAC code provided higher accuracy than previous methods (AUROC 0.88 vs. 0.50-0.81, p<0.001). Our new NAC algorithm, excluding AUD codes and selecting for a NAC or a primary decompensated cirrhosis condition code provided higher accuracy than previous approaches (AUORC 0.87 vs. 0.58-0.76, p<0.001). Using these new algorithms, we determined that between 2012-2022, AC hospitalization rates increased only for urban females, those <35 years of age, and for those living in regions with the highest area-level income. AH hospitalization rates increased predominantly for people <35 years and for females. During the COVID-19 pandemic AC/AH hospitalization rates significantly increased for those from rural and low-income areas. NAC hospitalization rates were not impacted by the COVID-19 pandemic, only increasing in people ≥65 years. Conclusions: The new case definitions exhibit enhanced AC/NAC identification accuracy compared to previous methods. Over the past decade, AC/AH hospitalizations increased in younger and female populations, and NAC hospitalizations steadily increased in older populations.
dc.identifier.citationSwain, L. A. (2024). Epidemiology of alcohol-related hepatitis, alcohol-related cirrhosis, and non-alcohol-related cirrhosis in Alberta, Canada: an administrative data validation and population-based study (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.urihttps://hdl.handle.net/1880/119229
dc.language.isoen
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgary
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectAlcohol-related liver disease
dc.subjectCirrhosis
dc.subjectHospitalization
dc.subjectICD-10
dc.subjectAdministrative database
dc.subjectCOVID-19
dc.subject.classificationEpidemiology
dc.titleEpidemiology of Alcohol-Related Hepatitis, Alcohol-Related Cirrhosis, and Non-Alcohol-Related Cirrhosis in Alberta, Canada: An Administrative Data Validation and Population-Based Study
dc.typemaster thesis
thesis.degree.disciplineMedicine – Community Health Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.thesis.accesssetbystudentI do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.
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