ArticleInternational journal for equity in health2020
Hospitalisation for cirrhosis in Australia: disparities in presentation and outcomes for Indigenous Australians.
Article in International journal for equity in health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Epidemiology of Patients With Chronic Liver Disease Presenting to Emergency Departments in Australia.Emergency medicine Australasia : EMA · 2026Article
- Contemporary global epidemiology of cirrhosis.Hepatology communications · 2026Review
- A population-based study of cause-specific mortality in First Nations Australians with cirrhosis: impact of cardiometabolic comorbidities and liver disease risk factors.The Lancet regional health. Western Pacific · 2025Article
- The impact of genetics and the environment on cancer risk in Indigenous Australians: a narrative review.The Lancet regional health. Western Pacific · 2025Review
- High prevalence of diabetes among young First Nations Peoples with metabolic dysfunction-associated steatotic liver disease: a population-based study in Australia.International journal for equity in health · 2024Article
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- Poor disease knowledge is associated with higher healthcare service use and costs among patients with cirrhosis: an exploratory study.BMC gastroenterology · 2022Article
- Standards of liver cirrhosis care in Central Australia.World journal of hepatology · 2022Article
- The seasonality of infections in tropical Far North Queensland, Australia: A 21-year retrospective evaluation of the seasonal patterns of six endemic pathogens.PLOS global public health · 2022Article
- Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study.Patient preference and adherence · 2021Article
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8 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIndigenous Australians experience greater health disadvantage and have a higher prevalence of many chronic health conditions. Liver diseases leading to cirrhosis are among the most common contributor to the mortality gap between Indigenous and other Australian adults. However, no comparative data exist assessing differences in presentation and patient outcomes between Indigenous and non-Indigenous Australians hospitalised with cirrhosis.
methodsUsing data from the Hospital Admitted Patient Data Collection and the Death Registry, this retrospective, population-based, cohort study including all people hospitalised for cirrhosis in the state of Queensland during 2008-2017 examined rate of readmission (Poisson regression), cumulative survival (Kaplan-Meier), and assessed the differences in survival (Multivariable Cox regression) by Indigenous status. Predictor variables included demographic, health service characteristics and clinical data.
resultsWe studied 779 Indigenous and 10,642 non-Indigenous patients with cirrhosis. A higher proportion of Indigenous patients were younger than 50 years (346 [44%] vs. 2063 [19%] non-Indigenous patients), lived in most disadvantaged areas (395 [51%) vs. 2728 [26%]), had alcohol-related cirrhosis (547 [70%] vs. 5041 [47%]), had ascites (314 [40%] vs. 3555 [33%), and presented to hospital via the Emergency Department (510 [68%] vs. 4790 [47%]). Indigenous patients had 3.04 times the rate of non-cirrhosis readmissions (95%CI 2.98-3.10), 1.35 times the rate of cirrhosis-related readmissions (95%CI 1.29-1.41), and lower overall survival (17% vs. 27%; unadjusted hazard ratio (HR) = 1.16 95%CI 1.06-1.27), compared to non-Indigenous patients. Most of the survival deficit was explained by Emergency Department presentation (adj-HR = 1.03 95%CI 0.93-1.13), and alcohol-related aetiology (adj-HR = 1.08 95%CI 0.99-1.19). The remaining survival deficit was influenced by the other clinico-demographic and health service factors (final adj-HR = 1.08 95%CI 0.96-1.20).
conclusionsThere was evidence of differential presentation, higher rates of readmissions, and poorer survival for Indigenous Australians with cirrhosis, compared to other Australians. The increased prevalence of Emergency Department presentation among Indigenous patients suggests missed opportunities for early intervention to prevent progressive cirrhosis complications and hospital readmissions.
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