# The Epidemiology of Ascites in a Multi‐Ethnic Asian Population

## TL;DR

This study examines the causes of ascites in a diverse Asian population, finding that cancer and liver disease are most common, with differences based on ethnicity.

## Contribution

The study provides new epidemiological data on ascites in a multi-ethnic Asian population, highlighting ethnic variations in causes.

## Key findings

- Malignancy and liver cirrhosis are the leading causes of ascites in the studied population.
- Ethnic differences in ascites etiology were observed, with malignancy most common in Chinese, heart failure in Malays, and chronic liver disease in Indians.

## Abstract

Ascites is a common condition seen by clinicians in secondary care. Data on the epidemiology of ascites in Asians is lacking.

A retrospective case record review was performed in this large, referral institution between January 2016 and December 2019. Clinical and epidemiological data of adult (age > 18 years) patients with ascites, identified from the Radiology database, were obtained from this institutions' electronic medical records.

A total of 838 patients (median age 59.77 ± 14.46 years, 56% males, ethnicity: Chinese 41.9%, Malay 34.8%, Indian 22.7%) were included in the study. Malignancy (28.9%) and liver cirrhosis (27.9%) were the most common etiology of ascites. Most of the malignant etiology of ascites were due to female‐related (breast and ovarian) and gastrointestinal (colon, liver, pancreatic, bile duct) cancer. Liver cirrhosis‐related ascites was mostly due to metabolic‐associated fatty liver disease (MASLD, 35.5%) and hepatitis B infection (20.5%). An increased age (> 40 years) was associated with all causes of ascites. The etiology of ascites varied with ethnicity as follows: the most common cause of ascites was malignancy (37.6%) among ethnic Chinese, heart failure (20.5%) in ethnic Malays and chronic liver disease (43.7%) in ethnic Indians.

Malignancy and liver cirrhosis are the leading cause of ascites in a multi‐ethnic Asian population. Demographic factors, particularly ethnicity, have a strong influence on the etiology of ascites.