Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study

• Published in: BMC gastroenterology 2007-02, Vol.7 (1), p.5-5, Article 5
• Main Authors: Russmann, Stefan, Dowlatshahi, Emmilia A, Printzen, Gert, Habicht, Susanne, Reichen, Jürg, Zimmermann, Heinz
• Format: Article
• Language: English
• Subjects: Adult; Cross-Sectional Studies; Emergency Service, Hospital; Female; Hepatitis B - blood; Hepatitis B - epidemiology; Hepatitis B Antibodies - blood; Hepatitis C - blood; Hepatitis C - epidemiology; Hepatitis C Antibodies - blood; Hospitals, University; Humans; Liver Function Tests; Male; Middle Aged; Prevalence; Switzerland; Transferrin - metabolism
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/1471-230X-7-5

The epidemiology of liver disease in patients admitted to emergency rooms is largely unknown. The current study aimed to measure the prevalence of viral hepatitis B and C infection and pathological laboratory values of liver disease in such a population, and to study factors associated with these measurements. Cross-sectional study in patients admitted to the emergency room of a university hospital. No formal exclusion criteria. Determination of anti-HBs, anti-HCV, transferrin saturation, alanine aminotransferase, and obtaining answers from a study-specific questionnaire. The study included 5'036 patients, representing a 14.9% sample of the target population during the study period. Prevalence of anti-HBc and anti-HCV was 6.7% (95%CI 6.0% to 7.4%) and 2.7% (2.3% to 3.2%), respectively. Factors independently associated with positive anti-HBc were intravenous drug abuse (OR 18.3; 11.3 to 29.7), foreign country of birth (3.4; 2.6 to 4.4), non-white ethnicity (2.7; 1.9 to 3.8) and age > or =60 (2.0; 1.5 to 2.8). Positive anti-HCV was associated with intravenous drug abuse (78.9; 43.4 to 143.6), blood transfusion (1.7; 1.1 to 2.8) and abdominal pain (2.7; 1.5 to 4.8). 75% of all participants were not vaccinated against hepatitis B or did not know their vaccination status. Among anti-HCV positive patients only 49% knew about their infection and 51% reported regular alcohol consumption. Transferrin saturation was elevated in 3.3% and was associated with fatigue (prevalence ratio 1.9; 1.2 to 2.8). Emergency rooms should be considered as targets for public health programs that encourage vaccination, patient education and screening of high-risk patients for liver disease with subsequent referral for treatment if indicated.