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©The Author(s) 2023.
World J Hepatol. Jan 27, 2023; 15(1): 89-106
Published online Jan 27, 2023. doi: 10.4254/wjh.v15.i1.89
Published online Jan 27, 2023. doi: 10.4254/wjh.v15.i1.89
Table 1 International Classification of Diseases-10 code case definition for liver disease aetiology, stratified into hierarchical tiers based of clinical importance
Tier 1 | Tier 2 | Tier 3 | ||||||
Descriptor | ICD-10 code | Descriptor | ICD-10 code | Descriptor | ICD-10 code | |||
Autoimmune liver disease | Autoimmune hepatitis | K75.4 | Hepatitis not specified | Inflammatory liver disease unspecified | K76.9 | Miscellaneous | Peliosis hepatis | K76.4 |
Primary biliary cholangitis | K74.3 | Other specified inflammatory liver disease | K75.8 | Other specified diseases of the liver | K76.8 | |||
Granulomatous hepatitis not elsewhere specified | K75.3 | Chronic hepatitis not elsewhere classified | K73.0-K73.9 | Liver disorders in diseases classified elsewhere | K77 | |||
Metabolic liver disease | Haemochromatosis | E83.11 | Congestive hepatopathy | Chronic passive congestion of the liver | K76.1 | |||
Alpha 1 anti-trypsin deficiency | E88.01 | Central haemorrhagic necrosis of the liver | K76.2 | |||||
Wilson’s disease | E83.01 | Hepatic veno-occlusive disease | K76.5 | |||||
HBV | Hepatitis B without D | B18.1 | Toxic liver disease | Toxic liver disease | K71 | |||
Hepatitis B with D | B18.0 | |||||||
HCV | Hepatitis C | B18.2 | ||||||
Alcohol-related liver disease | Alcoholic liver disease | K70-K70.9 | ||||||
Non-alcoholic fatty liver disease | Non-alcoholic fatty liver disease | K76.0 |
Table 2 International Classification of Diseases-10 codes to define the advanced stages of liver disease
Aetiological diagnoses (stage 1) | Cirrhosis (stage 2) | Portal hypertension (stage 3) | Hepatic decompensation (stage 4) | Hepatocellular carcinoma (stage 5) |
As defined in Table 1 | Alcoholic cirrhosis, K70.3 | Portal hypertension, K76.6 | Chronic hepatic failure, K72.1 | Primary liver cancer C22.0 |
Hepatic fibrosis or sclerosis, K74.0-K74.2 | Portal vein thrombosis, I81 | Hepatorenal syndrome, K76.7 | Hepatocellular carcinoma C22.1 | |
Secondary biliary cirrhosis, K74.4 | Oesophageal varices without bleeding I85.9 | Oesophageal varices with bleeding, I85.0 | ||
Biliary cirrhosis unspecified, K74.5 | Oesophageal varices without bleeding in diseases specified elsewhere, I98.2 | Hepatic failure unspecified K72 | ||
Cirrhosis, other, K74.6 |
Table 3 The number, age and sex of individuals with aetiological liver disease diagnoses in Wales 1999-2019 following application of aetiology hierarchy
Aetiology | n | % of total cohort | Mean/median age (yr) | % male |
Tier 1 | ||||
ArLD | 16143 | 26.1% | 54.9/55 | 67.8% |
NAFLD | 13390 | 21.6% | 57/58 | 47% |
Metabolic | 7131 | 11.5% | 63/67 | 52.5% |
HCV | 2889 | 4.7% | 43/41 | 66.8% |
ArLD overlap | 2979 | 4.8% | 51.2/51 | 65.3% |
Autoimmune liver diseases | 2312 | 3.7% | 61.8/64 | 20.5% |
HBV | 904 | 1.5% | 43.5/39 | 53.3% |
Non ArLD overlap | 955 | 1.5% | 51.2/51 | 55.8% |
Tier 2 | ||||
Hepatitis not specified | 6069 | 9.8% | 63/66 | 50.9% |
Congestive hepatopathy | 894 | 1.4% | 64.7/70 | 49.6% |
Toxic liver disease | 820 | 1.3% | 46.3/44 | 38.4% |
Tier 3 | ||||
Miscellaneous | 7430 | 12% | 66.7/70 | 42% |
Table 4 Progression of liver disease over 10 years by aetiology
0 | 6 mo | 1 yr | 2 yr | 3 yr | 5 yr | 10 yr | |
ArLD | |||||||
Stage 1 | 48.75 | 40.27 | 36.14 | 31.54 | 28.36 | 24.21 | 19.18 |
Stage 2 | 16.52 | 14.12 | 12.93 | 11.75 | 10.82 | 9.65 | 7.87 |
Stage 3 | 13.47 | 13.93 | 13.92 | 12.8 | 11.86 | 10.18 | 8.1 |
Stage 4 | 4.49 | 4.8 | 5.09 | 5.3 | 5.33 | 4.97 | 4.25 |
Stage 5 | 0.63 | 0.5 | 0.49 | 0.44 | 0.38 | 0.34 | 0.34 |
Stage 6 | 16.14 | 26.38 | 31.43 | 38.17 | 43.25 | 50.64 | 60.25 |
NAFLD | |||||||
Stage 1 | 86.3 | 82.52 | 80.42 | 77.98 | 76.25 | 73.93 | 70.7 |
Stage 2 | 2.54 | 2.28 | 2.31 | 2.21 | 2.22 | 2.18 | 1.98 |
Stage 3 | 2.87 | 2.99 | 2.87 | 2.7 | 2.52 | 2.29 | 2.07 |
Stage 4 | 0.82 | 0.93 | 0.98 | 1.01 | 1.01 | 0.95 | 0.91 |
Stage 5 | 0.4 | 0.38 | 0.36 | 0.28 | 0.3 | 0.22 | 0.24 |
Stage 6 | 7.07 | 10.89 | 13.07 | 15.82 | 17.71 | 20.43 | 24.1 |
Autoimmune liver disease | |||||||
Stage 1 | 72.94 | 66.33 | 63.31 | 59.57 | 56.44 | 51.89 | 44.83 |
Stage 2 | 10.79 | 10.53 | 10.12 | 9.67 | 9.07 | 8.51 | 7.73 |
Stage 3 | 8.7 | 9.29 | 9.41 | 9.07 | 8.77 | 7.69 | 6.83 |
Stage 4 | 2.43 | 2.8 | 2.84 | 2.95 | 3.02 | 3.21 | 2.99 |
Stage 5 | 0.86 | 0.9 | 0.82 | 0.67 | 0.63 | 0.56 | 0.6 |
Stage 6 | 4.29 | 10.15 | 13.51 | 18.07 | 22.06 | 28.14 | 37.03 |
HBV | |||||||
Stage 1 | 88.96 | 86.25 | 84.58 | 82.6 | 81.46 | 79.69 | 78.02 |
Stage 2 | 2.5 | 1.77 | 1.98 | 1.98 | 1.88 | 1.88 | 1.88 |
Stage 3 | 2.71 | 2.71 | 2.5 | 2.5 | 2.4 | 1.98 | 2.08 |
Stage 4 | 0.94 | 1.04 | 1.04 | 0.94 | 0.94 | 1.04 | 1.25 |
Stage 5 | 2.19 | 1.46 | 1.25 | 1.25 | 1.25 | 0.94 | 0.83 |
Stage 6 | 2.71 | 6.77 | 8.65 | 10.73 | 12.08 | 14.48 | 15.94 |
HCV | |||||||
Stage 1 | 88.02 | 85.5 | 83.54 | 80.68 | 78.51 | 75.38 | 71.59 |
Stage 2 | 4.15 | 3.88 | 3.94 | 4.06 | 4.12 | 4.06 | 3.61 |
Stage 3 | 2.8 | 2.59 | 2.53 | 2.53 | 2.59 | 2.35 | 2.29 |
Stage 4 | 0.87 | 1.05 | 1.14 | 1.17 | 1.2 | 1.17 | 1.2 |
Stage 5 | 1.38 | 1.2 | 1.17 | 1.11 | 1.08 | 1.17 | 1.17 |
Stage 6 | 2.77 | 5.78 | 7.67 | 10.44 | 12.49 | 15.86 | 20.13 |
Metabolic | |||||||
Stage 1 | 82.03 | 67.35 | 63.3 | 59.25 | 56.3 | 52.51 | 47.7 |
Stage 2 | 1.73 | 1.37 | 1.29 | 1.21 | 1.16 | 1.11 | 1.05 |
Stage 3 | 1.36 | 1.24 | 1.16 | 1.2 | 1.07 | 0.99 | 0.96 |
Stage 4 | 0.63 | 0.52 | 0.53 | 0.57 | 0.56 | 0.56 | 0.49 |
Stage 5 | 0.56 | 0.4 | 0.24 | 0.23 | 0.23 | 0.28 | 0.23 |
Stage 6 | 13.69 | 29.12 | 33.48 | 37.54 | 40.69 | 44.55 | 49.57 |
Congestive hepatopathy | |||||||
Stage 1 | 70.36 | 55.3 | 50.05 | 43.44 | 38.58 | 34.79 | 31.1 |
Stage 2 | 2.24 | 1.65 | 1.65 | 1.07 | 0.78 | 0.58 | 0.58 |
Stage 3 | 3.21 | 3.01 | 2.62 | 2.33 | 2.04 | 1.94 | 1.46 |
Stage 4 | 2.04 | 1.75 | 1.75 | 1.75 | 1.94 | 1.85 | 2.04 |
Stage 5 | 0.68 | 0.29 | 0.29 | 0.29 | 0.29 | 0.19 | 0.19 |
Stage 6 | 21.48 | 38 | 43.63 | 51.12 | 56.37 | 60.64 | 64.63 |
Toxic | |||||||
Stage 1 | 80.87 | 76.09 | 73.96 | 71.31 | 69.48 | 67.45 | 62.87 |
Stage 2 | 1.22 | 0.92 | 1.02 | 0.81 | 0.71 | 0.61 | 0.61 |
Stage 3 | 1.63 | 1.93 | 1.73 | 1.42 | 1.73 | 1.53 | 1.42 |
Stage 4 | 3.46 | 3.15 | 3.36 | 3.26 | 3.36 | 3.15 | 2.95 |
Stage 5 | 0.31 | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 | 0.1 |
Stage 6 | 12.51 | 17.7 | 19.74 | 22.99 | 24.52 | 27.06 | 32.04 |
Miscellaneous | |||||||
Stage 1 | 91.24 | 80.46 | 75.76 | 70.45 | 67.05 | 63.04 | 57.4 |
Stage 2 | 0.62 | 0.57 | 0.49 | 0.42 | 0.35 | 0.31 | 0.29 |
Stage 3 | 0.94 | 0.97 | 0.99 | 0.94 | 0.94 | 0.9 | 0.75 |
Stage 4 | 0.37 | 0.34 | 0.37 | 0.39 | 0.39 | 0.35 | 0.37 |
Stage 5 | 0.62 | 0.64 | 0.57 | 0.45 | 0.38 | 0.35 | 0.28 |
Stage 6 | 6.21 | 17.02 | 21.82 | 27.35 | 30.89 | 35.04 | 40.91 |
- Citation: Pembroke TPI, John G, Puyk B, Howkins K, Clarke R, Yousuf F, Czajkowski M, Godkin A, Salmon J, Yeoman A. Rising incidence, progression and changing patterns of liver disease in Wales 1999-2019. World J Hepatol 2023; 15(1): 89-106
- URL: https://www.wjgnet.com/1948-5182/full/v15/i1/89.htm
- DOI: https://dx.doi.org/10.4254/wjh.v15.i1.89