Aetiology and outcomes of emergency admissions for chronic liver disease in England, 2012–2019: a national cohort study using administrative data

OBJECTIVE: Chronic liver disease (CLD) deaths in the UK have risen fivefold since 1970. People with CLD often present with advanced disease. We investigated trends in aetiology, care, and outcomes of patients with a first emergency admission (FEA) for CLD in England. METHODS: In a retrospective cohort study, we analysed national administrative data of hospital admissions (Hospital Episode Statistics Admitted Patient Care data) to identify patients with a FEA for CLD between April 2012 and March 2019. We used negative binomial, logistic and proportional hazards regression to explore time trends in admission numbers according to population size, demographics, aetiology, readmissions, mortality, transplantation, and the treating clinicians' specialty. RESULTS: There were 83 527 FEAs for CLD during the 7-year study period, with numbers increasing each year. There was no evidence of a time trend when population size was taken into account (p=0.51). Of these FEAs, 65.3% had alcohol-related aetiologies. The proportion of FEAs with viral aetiologies decreased (7.3% in 2012-2014 vs 5.6% in 2016-2019; p