PT  - JOURNAL ARTICLE
AU  - Gao, Jingwei
AU  - Akbari, Ashley
AU  - Ahmed, Haroon
AU  - Davies, Aled
AU  - Yeoman, Andrew
AU  - Pembroke, Thomas Peter Ignatius
TI  - Incidence rate and associated patient characteristics of liver disease in Wales 2004–2022: a retrospective population-scale observational study
AID  - 10.1136/bmjopen-2024-093335
DP  - 2025 Feb 01
TA  - BMJ Open
PG  - e093335
VI  - 15
IP  - 2
4099  - http://bmjopen.bmj.com/content/15/2/e093335.short
4100  - http://bmjopen.bmj.com/content/15/2/e093335.full
SO  - BMJ Open2025 Feb 01; 15
AB  - Objective To describe the incidence and key demographic, socioeconomic and clinical characteristics of individuals with liver disease in Wales.Design and setting This study is designed as a retrospective observational study that linked data of anonymised identified individuals from primary, secondary care and mortality data from the Secure Anonymised Information Linkage (SAIL) Databank in Wales.Participants All Welsh residents who registered with a SAIL-contributing general practitioner (GP) and diagnosed with liver disease from 2004 to 2022.Primary and secondary outcome measures Our primary outcome is the annual age-standardised incidence rate of liver disease. Secondary outcome is the numbers and frequencies of underlying aetiology and the associated comorbidities.Results Between 2004 and 2022, 111 098 individuals received a diagnosis of liver disease in Wales and were included in this study. The incidence of liver disease increased threefold during the study period (97.7 per 100 000 inhabitants in 2004 to 316.2 per 100 000 inhabitants in 2022). A total of 79 992 individuals (72%) entered the cohort with the underlying aetiology of liver disease, including alcohol-related liver disease, non-alcoholic fatty liver disease (NAFLD), viral hepatitis, metabolic, haemochromatosis and autoimmune liver diseases. NAFLD has contributed to most of the change in incidence.Conclusions We observed increasing incidence rates of liver disease in Wales, with NAFLD showing a particularly sharp increase and frequently identified as an underlying condition. A better understanding of the incidence of liver disease is the first step towards effective prevention, early detection and targeted intervention to improve patient outcomes.Data may be obtained from a third party and are not publicly available. The routine data used in this study are available in the SAIL Databank at Swansea University, Swansea, UK. All proposals to use SAIL data are subject to review by an Information Governance Review Panel (IGRP). Before any data can be accessed, approval must be given by the IGRP. The IGRP gives careful consideration to each project to ensure proper and appropriate use of SAIL data. When access has been approved, it is gained through a privacy-protecting trusted research environment (TRE). SAIL has established an application process to be followed by anyone who would like to access data via SAIL https://www.saildatabank.com/application-process. This study has been approved by the IGRP as project 1492. The research adhered to ethical guidelines and the Data Protection Act 2018 to ensure the privacy and confidentiality of all data subjects involved. The reproducible SQL and R code and code lists to identify study individuals are available on Github: https://github.com/SwanseaUniversityDataScience/1492-LDCP.