Global, regional, and national burden and quality of care index of liver cirrhosis by cause from global burden of disease 1990–2019
Fateme Gorgani
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorZahra Esfahani
Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSeyyed-Hadi Ghamari
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorErfan Ghasemi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSina Azadnajafabad
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorParnian Shobeiri
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorEsmaeil Mohammadi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSahar Saeedi Moghaddam
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorMohsen Abbasi-Kangevari
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorNima Fattahi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina, USA
Search for more papers by this authorYeganeh Sharifnejad Tehrani
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorYosef Farzi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorCorresponding Author
Negar Rezaei
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Correspondence
Dr Negar Rezaei, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, No. 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, Iran.
Email: [email protected]
Search for more papers by this authorBagher Larijani
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorFarshad Farzadfar
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorFateme Gorgani
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorZahra Esfahani
Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSeyyed-Hadi Ghamari
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorErfan Ghasemi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSina Azadnajafabad
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorParnian Shobeiri
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorEsmaeil Mohammadi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSahar Saeedi Moghaddam
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorMohsen Abbasi-Kangevari
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorNima Fattahi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina, USA
Search for more papers by this authorYeganeh Sharifnejad Tehrani
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorYosef Farzi
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorCorresponding Author
Negar Rezaei
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Correspondence
Dr Negar Rezaei, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, No. 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, Iran.
Email: [email protected]
Search for more papers by this authorBagher Larijani
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorFarshad Farzadfar
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorFateme Gorgani and Zahra Esfahani contributed equally as first authors.
Declaration of conflict of interest: None is declared.
Author contributions: Study concept and design: F.F., N.R., and B.L. Acquisition of data: S.S.M., F.G., and Z.E. Analysis and interpretation of data: Z.E., S.S.M., P.S.H., Y.S.T. Drafting of the manuscript: F.G., S.-H.G., and S.A. Critical revision of the manuscript for important intellectual content: F.G., E.M., S.A., E.M., N.F., S.-H.G., M.A.-K., Y.F., N.R. Statistical analysis: Z.E., S.S.M., P.S.H., and Y.S.T. Administrative, technical, or material support: N.R., F.F., and B.L. Study supervision: N.R., F.F., and B.L. All authors have read and approved the manuscript prior to submission.
Ethical approval: This study was approbated by the institutional review board of Endocrinology and Metabolism Research Institute at Tehran University of Medical Sciences (IR.TUMS.EMRI.REC.1400.012).
Abstract
Background and Aim
Cirrhosis and other chronic liver diseases are complex disorders with a known burden. Currently health systems have different approaches to dealing with this issue. The objective of this study is to describe the burden attributed to and quality of care for cirrhosis and other chronic liver diseases.
Methods
Data of cirrhosis and other chronic liver diseases extracted from Global-Burden-of-Diseases 2019. Four indicators, including mortality to incidence ratio, prevalence to incidence ratio, disability-adjusted-life-years (DALYs) to prevalence ratio, and years-of-life-lost (YLLs) to years-lived-with-disability (YLDs) ratio, were defined and combined by the principal-components-analysis to construct the Quality-of-Care-Index (QCI).
Results
The global QCI of cirrhosis increased from 71.0 in 1990 to 79.3 in 2019. The QCI showed a favorable situation in higher SDI countries compared with lower SDI countries, with a QCI of 86.8 in high SDI countries and 60.1 in low SDI countries. The highest QCI was found in Western Pacific Region (90.2), and the lowest was for African Region (60.4). Highest QCI belonged to the 50–54 age group (99.5), and the lowest was for the 30.34 age group (70.9). Among underlying causes of cirrhosis, the highest QCI belonged to alcohol use, followed by hepatitis C and NAFLD with QCIs of 86.1, 85.3, and 81.1.
Conclusions
There was a considerable variation in the QCI of cirrhosis and other chronic liver diseases. Countries with low QCI, mainly located in developing regions, need organized action to control the burden of cirrhosis and its underlying causes and improve their quality of care.
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