Comorbid occurrence of liver and pancreas disease in United States military veterans.

Abstract

The clinical epidemiology of the comorbidity between liver and pancreas disease is unknown. The Patient Treatment File of the Department of Veterans Affairs contains the computerized records of all inpatients treated in 172 Department of Veterans Affairs hospitals distributed throughout the United States. This large database offers a unique opportunity to study the epidemiology of liver-pancreas comorbidity (LPC). In a case-control study, 6,393 LPC cases were compared to 34,513 controls with alcoholic liver disease and liver cirrhosis alone and 68,038 controls without liver or pancreas disease. Multivariate logistic regression analysis was used to assess the joint influence of multiple risk factors on the occurrence of LPC. LPC occurred in 15.6% of patients with alcoholic liver disease and liver cirrhosis identified in the Patient Treatment File between 1990 and 1993. Compared to controls with liver disease alone, LPC cases were characterized by younger age (odds ratio = 0.88 per age decade, CI = 0.86-0.90) and African American (2.33, 2.18-2.48) or Hispanic (1.24, 1.12-1.38) ethnicity. Compared to controls with neither liver nor pancreas disease, LPC cases were characterized by male gender (1.67, 1.28-2.17), African American (1.41, 1.32-1.50) or Hispanic (2.04, 1.82-2.30) ethnicity, more frequent history of alcoholism (29.5, 26.7-32.6), and being divorced (1.35, 1.26-1.44). Comorbidity of liver and pancreas disease is relatively common in the veteran population. Such patients are more frequently divorced and of African American or Hispanic ethnicity, and present with a history of excessive alcoholism at a relatively young age.