Hepatic failure

Metadata

Name	Hepatic failure (liver_fail)
Category	Digestive
Sex
Adult	Yes
UUID	1f49dfc5-f2cd-414e-98f5-d0c041587c36
Definition	Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology.

Ontologies

Disease Ontology (DOID)	DOID_13413
GWAS Catalogue	HP_0001399
MeSH	D017093
SNOMED-CT	59927004
FinnGen	K11_HEPFAIL

Key Summary Statistics

Cases from any source

Total	1728
Female (%)	661 (38%)
Male (%)	1067 (62%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	8.13 (6.22,10.05)
Male	9.66 (7.38,11.94)

Incidence stratified by sex

Female	1.18 (0.9,1.46)
Male	2.11 (1.69,2.52)

Incidence stratified by age

Ages 40-44	0.8 (0.25,1.36)
Ages 45-49	0.67 (0.23,1.1)
Ages 50-54	1.2 (0.66,1.74)
Ages 55-59	2.08 (1.44,2.72)
Ages 60-64	1.73 (1.22,2.23)
Ages 65-69	2.31 (1.64,2.98)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	6 (4,9)	12 (9,15)	16 (14,19)
CALIBER	15 (14,16)	23 (22,24)	26 (25,28)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	4(1,11)	6(2,11)	9(5,14)
Low	4(1,12)	7(4,14)	12(8,18)
Medium	3(0,11)	10(5,18)	13(8,19)
High	7(3,15)	14(8,23)	24(17,33)
Most deprived	11(5,19)	20(13,30)	26(19,35)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	6(4,9)	12(9,15)	17(14,21)
Scotland	6(1,17)	13(6,23)	12(7,21)
Wales	7(1,24)	10(3,23)	11(4,22)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=153646, Events=402

Factor	Level	Hazard Ratio	P value
BMI	overweight	1.07 (0.82, 1.39)	0.637
BMI	obese	2.13 (1.65, 2.77)	1.06e-08
BMI	underweight	0 (0, Inf)	0.986
smoking	previous	1.48 (1.19, 1.85)	0.000498
smoking	current	2.47 (1.87, 3.26)	1.43e-10
hypertension	yes	2.21 (1.8, 2.72)	5.76e-14

Definition

UK Biobank field id	Description	Code	Value
20002	Non-cancer illness code, self-reported	1158	liver failure/cirrhosis
41202	Diagnoses - main ICD10	B15.0	Hepatitis A with hepatic coma
41202	Diagnoses - main ICD10	B16.0	Acute hepatitis B with delta-agent (coinfection) with hepatic coma
41202	Diagnoses - main ICD10	B19.0	Unspecified viral hepatitis with hepatic coma
41202	Diagnoses - main ICD10	K70.4	Alcoholic hepatic failure
41202	Diagnoses - main ICD10	K71.1	Toxic liver disease with hepatic necrosis
41202	Diagnoses - main ICD10	K72	Hepatic failure, not elsewhere classified
41202	Diagnoses - main ICD10	K76.2	Central haemorrhagic necrosis of liver
41202	Diagnoses - main ICD10	K76.3	Infarction of liver
41204	Diagnoses - secondary ICD10	B15.0	Hepatitis A with hepatic coma
41204	Diagnoses - secondary ICD10	B16.0	Acute hepatitis B with delta-agent (coinfection) with hepatic coma
41204	Diagnoses - secondary ICD10	B19.0	Unspecified viral hepatitis with hepatic coma
41204	Diagnoses - secondary ICD10	K70.4	Alcoholic hepatic failure
41204	Diagnoses - secondary ICD10	K71.1	Toxic liver disease with hepatic necrosis
41204	Diagnoses - secondary ICD10	K72	Hepatic failure, not elsewhere classified
41204	Diagnoses - secondary ICD10	K76.2	Central haemorrhagic necrosis of liver
41204	Diagnoses - secondary ICD10	K76.3	Infarction of liver
40001	Underlying (primary) cause of death: ICD10	B15.0	Hepatitis A with hepatic coma
40001	Underlying (primary) cause of death: ICD10	B16.0	Acute hepatitis B with delta-agent (coinfection) with hepatic coma
40001	Underlying (primary) cause of death: ICD10	B19.0	Unspecified viral hepatitis with hepatic coma
40001	Underlying (primary) cause of death: ICD10	K70.4	Alcoholic hepatic failure
40001	Underlying (primary) cause of death: ICD10	K71.1	Toxic liver disease with hepatic necrosis
40001	Underlying (primary) cause of death: ICD10	K72	Hepatic failure, not elsewhere classified
40001	Underlying (primary) cause of death: ICD10	K76.2	Central haemorrhagic necrosis of liver
40001	Underlying (primary) cause of death: ICD10	K76.3	Infarction of liver
40002	Contributory (secondary) causes of death: ICD10	B15.0	Hepatitis A with hepatic coma
40002	Contributory (secondary) causes of death: ICD10	B16.0	Acute hepatitis B with delta-agent (coinfection) with hepatic coma
40002	Contributory (secondary) causes of death: ICD10	B19.0	Unspecified viral hepatitis with hepatic coma
40002	Contributory (secondary) causes of death: ICD10	K70.4	Alcoholic hepatic failure
40002	Contributory (secondary) causes of death: ICD10	K71.1	Toxic liver disease with hepatic necrosis
40002	Contributory (secondary) causes of death: ICD10	K72	Hepatic failure, not elsewhere classified
40002	Contributory (secondary) causes of death: ICD10	K76.2	Central haemorrhagic necrosis of liver
40002	Contributory (secondary) causes of death: ICD10	K76.3	Infarction of liver
42040	GP clinical event records	7L1f.00	Compensation for liver failure
42040	GP clinical event records	7L1fz00	Compensation for liver failure NOS
42040	GP clinical event records	A700.00	Viral hepatitis A with coma
42040	GP clinical event records	A702.00	Viral hepatitis B with coma
42040	GP clinical event records	A704000	Viral hepatitis C with coma
42040	GP clinical event records	A704.00	Other specified viral hepatitis with coma
42040	GP clinical event records	A704z00	Other specified viral hepatitis with hepatic coma NOS
42040	GP clinical event records	J600000	Acute hepatic failure
42040	GP clinical event records	J600011	Acute liver failure
42040	GP clinical event records	J600200	Acute yellow atrophy
42040	GP clinical event records	J600.00	Acute necrosis of liver
42040	GP clinical event records	J600z00	Acute necrosis of liver NOS
42040	GP clinical event records	J601000	Subacute hepatic failure
42040	GP clinical event records	J601200	Subacute yellow atrophy
42040	GP clinical event records	J601.00	Subacute necrosis of liver
42040	GP clinical event records	J601z00	Subacute necrosis of liver NOS
42040	GP clinical event records	J60..00	Acute and subacute liver necrosis
42040	GP clinical event records	J60z.00	Acute and subacute liver necrosis NOS
42040	GP clinical event records	J613000	Alcoholic hepatic failure
42040	GP clinical event records	J622.00	Hepatic coma
42040	GP clinical event records	J622.11	Encephalopathy - hepatic
42040	GP clinical event records	J625.00	[X] Hepatic failure
42040	GP clinical event records	J625.11	[X] Liver failure
42040	GP clinical event records	J62y.11	Hepatic failure NOS
42040	GP clinical event records	J62y.12	Liver failure NOS
42040	GP clinical event records	J62y.13	Hepatic failure
42040	GP clinical event records	J634.00	Hepatic infarction
42040	GP clinical event records	J635100	Toxic liver disease with hepatic necrosis
42040	GP clinical event records	J635700	Acute hepatic failure due to drugs
42040	GP clinical event records	J636.00	Central haemorrhagic necrosis of liver
42040	GP clinical event records	SP08600	Liver transplant failure and rejection
42040	GP clinical event records	SP14200	Hepatic failure as a complication of care
42040	GP clinical event records	SP14211	Liver failure as a complication of care
42040	GP clinical event records	X3073	Alcoholic hepatic failure
42040	GP clinical event records	XE0bC	Other sequelae of chronic liver disease
42040	GP clinical event records	XaMuG	Compensation for liver failure
42040	GP clinical event records	XaMuI	Compensation for liver failure NOS
42040	GP clinical event records	XaJxp	Acute hepatic failure due to drugs
42040	GP clinical event records	XE0bB	Hepatic coma