Clinical ResearchDiabetes increases the risk of acute hepatic failure☆,☆☆
Section snippets
Databases
The study population was assembled from hospitalized veterans registered within the nationwide PTF. The PTF comprises a multitude of annual data files in which discharge diagnoses are recorded for each inpatient hospital visit since 1970. Individual patients can be traced through the annual files of the PTF through their unique social security numbers. Since 1981, discharge diagnoses have been coded according to the 9th revision of the Clinical Modification of International Classification of
Results
We identified 257,649 patients with diabetes and 772,947 patients without diabetes who were hospitalized in VA facilities between October 1985 and October 1990. Of these, 216,831 patients with diabetes and 765,853 patients without diabetes did not have liver disease in their hospitalization records as far back as 1980. After excluding all patients in whom liver disease was recorded during the first year of follow-up, 173,643 patients with diabetes and 650,620 patients without diabetes remained
Discussion
We are unaware of other studies that have specifically examined the incidence of acute liver failure in diabetic patients. In this large cohort study, we found that diabetes mellitus was associated with an approximately 1.5-fold increase in the risk of acute hepatic failure. This increased risk was not fully explained by the presence of underlying liver disease or concomitant known risk factors, such as viral hepatitis, chronic liver disease, alcoholism, congestive heart failure, or other major
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Address requests for reprints to: Hashem B. El-Serag, M.D., M.P.H., The Houston Veterans Affairs Medical Center (152), 2002 Holcombe Blvd., Houston, Texas 77030. e-mail: [email protected]; fax: (713) 748-7359.
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Dr. El-Serag is a Veterans Affairs Health Services Research and Development Awardee (RCD00-013-2).