Nonalcoholic fatty liver disease progression rates to cirrhosis and progression of cirrhosis to decompensation and mortality: a real world analysis of Medicare data

• DOI: 10.1111/apt.15679
• Publication Date: 2020-05-06T04:01:15Z
• Authors: Rohit Loomba; Robert Wong; Jeremy Fraysse; Sanatan Shreay; Suying Li; Stephen Harrison; Stuart C. Gordon
• Keywords: Dyslipidemia; Decompensation; Cumulative incidence

Summary Background Risk factors and timing associated with disease progression mortality in nonalcoholic fatty liver (NAFLD) are poorly understood. Aims To evaluate the impact of severity, demographics comorbidities on risk time to a large, real‐world cohort diagnosed NAFLD patients. Methods Claims data from 20% Medicare representative sample between 2007 2015 were analysed retrospectively. Adults categorised into severity groups: NAFLD/nonalcoholic steatohepatitis (NASH) alone, compensated cirrhosis, decompensated transplant or hepatocellular carcinoma. Cumulative incidence calculated for each group multivariate analyses performed adjusting demographics, severity. Results A total 10 826 456, patients assessed prevalence was 5.7% (N = 621 253). Among NAFLD, 71.1% had NAFLD/NASH alone 28.9% cirrhosis. Overall, 85.5% hypertension, 84.1% dyslipidemia, 68.7% cardiovascular 55.5% diabetes. The cumulative cirrhosis 39% 45%, respectively, over 8 years follow‐up. independent predictors included disease, renal impairment, dyslipidemia carcinoma 12.6%, 31.1%, 51.4% 76.2%, respectively. Conclusions present report (a) demonstrates that is grossly underdiagnosed clinical settings (b) provides new evidence rates across spectrum