Cohort profile: decoding the epidemiology of liver disease in Sweden (DELIVER)

Abstract

Background and aims

Swedish nationwide registries can be used to identify patients with a wide range of diagnoses. This information can be used to construct cohorts useful to determine prognosis and identify risk factors for disease progression. Here, we describe a new register-based cohort of patients with a diverse set of chronic liver disease diagnoses in Sweden.

Methods

The DELIVER (DEcoding the epidemiology of LIVER disease in sweden) was constructed using extensive data linkages between different Swedish registers, diagnosed between 1964 and 2016. Patients in DELIVER are matched 1:10 to reference individuals from the general population on age, sex, municipality and calendar year of first liver disease diagnosis. Longitudinal cross-linked data from several registers allow for identification of outcomes occurring before or after liver disease diagnosis. Further, since July 2005 all dispensed drugs can be identified.

Results

In total, 307 768 unique individuals with a diagnosis of a chronic liver disease since 1964 were identified, and these were matched with 3 067 714 reference individuals from the general population. As examples, DELIVER contains data on 90 948 patients with a diagnosis of viral hepatitis; 50 593 patients with alcohol-related liver disease and 13 242 patients with non-alcoholic fatty liver disease.

Conclusions

The DELIVER cohort can be used to examine several important research questions. Long-term outcomes of chronic liver diseases, risk factors for disease progression, impact of dispensed drugs, disease panorama and time trends are examples. Here we describe the construction and data availability of DELIVER.

Keywords:

• Liver disease
• epidemiology
• registry
• natural history

Author contributions

Study conception and design: HH; Acquisition of data: HH; Statistical analysis: LW; Analysis and interpretation of data: All; Drafting of manuscript: HH; Critical revision: All; Guarantor of article: HH; All authors approved the final version of the article, including the authorship list; Writing assistance: None.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

HH was supported by grants from Region Stockholm, The Swedish Cancer Society, Radiumhemmet Research Foundation, the Åke Wiberg Foundation and the Swedish Research Council.