CO35 | Changes in epidemiology of liver cirrhosis patients admitted to an Internal Medicine Unit from 2014 to 2023: a prospective analysis

Background: Metabolic-associated liver disease is increasing worldwide and end-stage liver disease is a frequent cause of admission to Internal Medicine (IM) Units. In this prospective study, we analyse the etiology and outcomes of admissions due to cirrhosis in a secondary hospital in Rome, Italy.Methods: All admissions to IM during 2014-2023 were prospectively recorded along with demographic data, diagnosis, hospital stay and outcome. Patients with cirrhosis were retrospectively analysed for etiology, comorbidities, and clinical outcomes.Results: 6932 admissions to IM from 2014 and 2023 were included; of these, 372 were due to cirrhosis (88% from the Emergency Department, 66.1% males, median age 71 years, IQR 23). Cirrhosis etiology was alcohol 45.4%, viral 44.3%, metabolic 17%, other 6.9%. Concomitant HCC was present in 24.7%; diabetes mellitus was present in 28% of cirrhotics. compared to 17.8% non-cirrhotics (p<0.001). Prevalence of viral etiology fell from 63% in 2014 to 41% in 2023 (p=0.04), while metabolic-associated cirrhosis increased from 6% in 2014 to 28% in 2023 (p=0.07). Mean hospital stay was 10.3±8 days and in-hospital mortality was 9.4% overall. Negative outcomes in cirrhotics (death, transfer to ICU, hospice care) fell from 26% in 2014 to 15.4% in 2023.Conclusions: In the past 10 years, worldwide changes in etiology of chronic liver disease are evident among patients with cirrhosis admitted to IM. Cirrhotic patients have a higher prevalence of diabetes mellitus compared to other IM patients, reflecting the increasing burden of metabolic liver disease.