Indicators Of Morbidity And Mortality From Diseases of the Digestive System in the Krasnodar Krai and the Quality of Medical Care for Gastroenterological Patients

Aim. To analyse the dynamics of morbidity and mortality from diseases of the digestive system, as well as the quality of medical care for gastroenterological patients in the Krasnodar Krai.

Materials and methods. The analysis was carried out according to C 51 “Distribution of deaths by gender, age groups and causes of death” form of the Territorial Authority of the Federal State Statistics Service for the Krasnodar Krai for the period from 2006 to 2018, as well as on the basis of the “Demography” block database of the Parus software of the healthcare management system of the Krasnodar Krai for 6 months of 2019. 1341 medical records of patients receiving outpatient medical care and the medical records of people who had died from digestive diseases in 2017-2019 were reviewed.

Results. Digestive diseases (DD) occupy the fourth place (7.1 %) in the structure of the general morbidity of the population in the Krasnodar Krai. Over the study period (13 years), the structure of mortality from DD has not changed significantly among the region’s population. About 70% of the causes of death from DD among people of working age account for liver diseases. The pathology of the pancreas takes the second place (13.5 %). The peptic ulcer of the stomach, duodenum and “other diseases of the digestive system” (8.8 % and 7.7 %, respectively) are represented in almost equal shares. In the etiological structure of liver cirrhosis, viral (39 %) and alcoholic (36 %) liver diseases are leading. The frequency of viral liver lesions tends to decrease, while the proportion of liver cirrhosis in the outcome of non-alcoholic fatty liver disease (NAFLD) progressively increase, having reached 7 % in 2017–2018. In the group of patients with inflammatory diseases of the pancreas, men prevail (66.9 %), often those abusing alcohol. The third leading cause of mortality from DD in the Krasnodar Territory is pathological conditions that occurred in the upper gastrointestinal tract (acute stomach ulcer, duodenal ulcer with bleeding, perforation) in older age groups taking antiplatelet agents and non-steroidal anti-inflammatory drugs (71.8 %). 

Conclusions. The main causes of death among the population of the Krasnodar Krai from diseases of the digestive system at a young age are alcohol consumption with unhealthy consequences. At the same time, people of older age groups die from a lack of prevention of ulceration and inadequate eradication of Helicobacter pylori in patients taking non-steroidal anti-inflammatory drugs and antiplatelet agents.

1. Nolte E., McKee M. Measuring the health of the nations: analysis of mortality amenable to health care. BMJ.2003;327:1129. DOI: 10.1136/bmj.327.7424.1129

2. Healthcare in Russia. 2015. Stat. Issue / Russtat. M., 2015. 174 p. (In Russ.)

3. Population health and health care organization in Krasnodar Regionin 2018 year: state report / Administration of Krasnodar Region, Ministry of health care of Krasnodar Region; edited by E.F. Filippov. Krasnodar: SBIHCMIAC. 162 p. (In Russ.)

4. http://www.euro.who.int/en/data-and-evidence/archive/mortality-database-updated

5. Khazanov A.I. 50-years monitoring of patients with hepatic cirrhosis. Rus J Gastroenterol Hepatol Coloproctol. 1998;8(2):50–60 (In Russ.)

6. Plyusnin S.V., Ivashkin K.V., Bobrov A.N., Belyakin S.A., Plyusnina I.V. Alcohol-induced liver disease: primary and secondary prevention. Rus J Gastroenterol Hepatol Coloproctol. 2015;25(3):42–8 (In Russ.)

7. Mayevskaya M.V., Bakulin I.G., Chirkov A.A., Lyusina Y.O., Lun’kov V.D. Alcohol abuse in gastroenterological patients. Rus J Gastroenterol Hepatol Coloproctol. 2016;26(4):24–35 (In Russ.) DOI: 10.22416/1382-4376-2016-26-4-24-35

8. Ivashkin V.T., Drapkina O.M., Shul’pekova Yu.O. Diagnostics and treatment of nonalcoholic steatosis liver disease: Method. recomendation. Moscow: M-Vesti, 2009. 20 p. (In Russ.)

9. Ivashkin V.T., Mayevskaya M.V., Pavlov C.S., Tikhonov I.N., Shirokova Y.N., Buyeverov A.O., Drapkina O.M., Shulpekova Y.O., Tsukanov V.V., Mammayev S.N., Mayev I.V., Palgova L.K. Diagnostics and treatment of non-alcoholic fatty liver disease: clinical guidelines of the Russian Scientific Liver Society and the Russian gastroenterological association. Rus J Gastroenterol Hepatol Coloproctol. 2016;26(2):24–42 (In Russ.) DOI: 10.22416/1382-4376-2016-26-2-24-42

10. Fagenholz P.J., Castillo C.F., Harris N.S. et al. Increasing United States hospital admissions for acute pancreatitis, 1988–2003. Ann Epidemiol. 2007;17:491–7.

11. Yadav D., Lowenfels A.B. Trends in the epidemiology of the first attack of acute pancreatitis: a systemic review. Pancreas 2006;33:323–30.

12. Brandt L., Fuerstadt P., Longstreth P., Boley S. ACG Clinical Guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia. Am J Gastroenterol. 2015;110:18–44.