The clinical presentation and outcomes of patients hospitalized with hepatitis B (HBV) are increasingly shaped by coexisting conditions and evolving mortality patterns. This study assessed the burden of comorbidities and fatality rates among patients hospitalized for the first time with HBV in Poland over a 12-year period (2012–2023), to characterize changing clinical needs and public health implications.
A retrospective nationwide analysis of first-time HBV hospitalizations in Poland was performed using data from the Nationwide General Hospital Morbidity Study. The investigation covered hospital admissions between 2012 and 2023 and focused on comorbidity categories, selected individual diagnoses, age-stratified patterns, and in-hospital fatality rates across the study period.
Across first-time HBV hospitalizations during 2012–2023, the most frequently recorded comorbidity categories were digestive diseases (15.6%), cardiovascular diseases (10.5%), and endocrine and metabolic disorders (9.6%). These categories represented the largest contributors to the overall multimorbidity profile documented in the nationwide dataset.
Temporal analysis identified several notable trends in comorbidity prevalence over the 12-year period. The proportion of patients with digestive disorders increased substantially, rising from 12.3% to 27.4% between 2012 and 2023. Endocrine and metabolic disorders also showed a marked increase, from 8.5% to 18.5% over the same interval. Circulatory disease comorbidity rose from 7.4% in early years to 18.6% by later years, with a pattern of increase followed by stabilization after 2019.
Some comorbidity categories exhibited sustained post-2019 growth: immune-related and genitourinary disorders were reported to increase continuously after 2019. Other categories, including neoplasms and respiratory diseases, followed a growth-decline pattern during the observation period, indicating heterogeneous temporal dynamics across diagnostic groups.
Among specific diagnoses recorded in first-time HBV hospitalizations, hypertension and liver fibrosis were the most frequent individual conditions. Both diagnoses demonstrated either sustained increases or stepwise rises across the study years. These individual-level patterns align with the broader rise in cardiometabolic and advanced hepatic disease components of the comorbidity mix.
Analyses stratified by age revealed a shift in clinical profiles across the lifespan. Younger patients admitted with HBV more commonly presented with infection-related conditions, whereas older patients increasingly exhibited cardiometabolic disorders and more advanced hepatic disease. This age-associated transition highlights differing clinical priorities: infection-focused management in younger cohorts and multimorbidity-driven, chronic disease care needs in older populations.
In-hospital fatality rates among patients with first-time HBV hospitalizations increased over the study period. During 2012–2019, fatality ranged between 6.8 and 15.9 deaths per 1000 hospitalizations. From 2020 to 2023, fatality rates rose to 23.1–30.7 per 1000 hospitalizations, with the highest rates observed during 2020–2021. Mortality was consistently higher in men than in women across the reported intervals.
The observed increase in fatality rates coincided with the period after 2019, a timeframe during which several comorbidity categories also increased, suggesting an association between rising multimorbidity and higher in-hospital mortality among first-time HBV admissions.
This nationwide study demonstrates that first-time hospitalizations for hepatitis B in Poland between 2012 and 2023 became increasingly characterized by multimorbidity and rising fatality rates, particularly among older patients. Digestive, circulatory, and endocrine/metabolic disorders emerged as dominant comorbidity categories, while hypertension and liver fibrosis were frequent individual diagnoses showing upward trends.
The findings signal a growing clinical and public health burden of HBV hospitalizations that extends beyond viral management to the comprehensive care of comorbid chronic diseases. The authors emphasize the need for integrated, age-tailored management strategies and improved surveillance to reduce mortality and optimize HBV care. Specific operational or policy recommendations beyond these general implications were not reported in the abstract.