ArticleJAMA neurology2017
Association Between Cirrhosis and Stroke in a Nationally Representative Cohort.
Article in JAMA neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 61 citations in OpenAlex.
- Association Between Cirrhosis and Acute or Severe Limb Ischemic Events Among Hospitalizations with Peripheral Artery Disease: A National Inpatient Sample Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Is FIB-4 Index an Independent Risk Factor for Hematoma Expansion in Acute Intracerebral Hemorrhage? A Retrospective Multicenter Observational Cohort Study.Journal of clinical medicine · 2026Article
- Syndemic analysis of stroke in Indonesia.The Lancet regional health. Western Pacific · 2026Article
- Spontaneous Intracranial Hemorrhage in Liver Failure: A Case-Based Approach to Transplant Candidacy and Care.Cureus · 2026Article
- Coagulation Abnormalities in Liver Cirrhosis: Diagnostic and Therapeutic Approaches.Medicina (Kaunas, Lithuania) · 2026Review
- Development and Validation of Dynamic Prediction Model for Thromboembolic and Bleeding Risk in Patients With Atrial Fibrillation Initiating Direct Oral Anticoagulants.Journal of the American Heart Association · 2025Article
- Association Between Liver Fibrosis and Risk of Incident Stroke and Mortality: A Large Prospective Cohort Study.Journal of the American Heart Association · 2025Article
- Cirrhosis Is an Independent Risk Factor for Mortality in Ischemic Stroke-A Nationwide Analysis.International journal of hepatology · 2025Article
- Association between stroke and memory diseases: evidence from a prospective national cohort study in China.Frontiers in neurology · 2025Article
- Comparative Effectiveness and Safety of Apixaban, Rivaroxaban, and Warfarin in Patients With Cirrhosis and Atrial Fibrillation : A Nationwide Cohort Study.Annals of internal medicine · 2024Article
- Risk of Cerebral Aneurysm Rupture After Liver Transplantation: Development and Validation of a Hemorrhagic Stroke Scoring Model.Journal of Korean medical science · 2024Article
- Hemorrhagic Transformation of Ischemic Strokes.International journal of molecular sciences · 2023Review
- Review
- Intensive care management of acute-on-chronic liver failure.Intensive care medicine · 2023Review
- A step-by-step guide for the diagnosis and management of hyponatraemia in patients with stroke.Therapeutic advances in endocrinology and metabolism · 2023Review
- Prevalence and Prognostic Significance of Liver Fibrosis in Patients With Aneurysmal Subarachnoid Hemorrhage.Frontiers in neurology · 2022Article
- Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study.Computational and mathematical methods in medicine · 2022Article
- Risk and Outcome of Venous and Arterial Thrombosis in Patients With Cirrhosis: A Danish Nation-wide Cohort Study.Hepatology (Baltimore, Md.) · 2021Article
- Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant.Brain sciences · 2021Article
- Lights and Shadows in Hepatic Encephalopathy Diagnosis.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Cirrhosis is associated with hemorrhagic and thrombotic extrahepatic complications. The risk of cerebrovascular complications is less well understood. Objective: To investigate the association between cirrhosis and various stroke types. Design, Setting, and Participants: We performed a retrospective cohort study using inpatient and outpatient Medicare claims data from January 1, 2008, through December 31, 2014, for a random 5% sample of 1 618 059 Medicare beneficiaries older than 66 years. Exposures: Cirrhosis, as defined by a validated diagnosis code algorithm. Main Outcomes and Measures: The primary outcome was stroke, and secondary outcomes were ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage as defined by validated diagnosis code algorithms. Results: Among 1 618 059 beneficiaries, 15 586 patients (1.0%) had cirrhosis (mean [SD] age, 74.1 [6.9] years; 7263 [46.6%] female). During a mean (SD) of 4.3 (1.9) years of follow-up, 77 268 patients were hospitalized with a stroke. The incidence of stroke was 2.17% (95% CI, 1.99%-2.36%) per year in patients with cirrhosis and 1.11% (95% CI, 1.10%-1.11%) per year in patients without cirrhosis. After adjustment for demographic characteristics and stroke risk factors, patients with cirrhosis had a higher risk of stroke (hazard ratio [HR], 1.4; 95% CI, 1.3-1.5). The magnitude of association appeared to be higher for intracerebral hemorrhage (HR, 1.9; 95% CI, 1.5-2.4) and subarachnoid hemorrhage (HR, 2.4; 95% CI, 1.7-3.5) than for ischemic stroke (HR, 1.3; 95% CI, 1.2-1.5). Conclusions and Relevance: In a nationally representative sample of Medicare beneficiaries, cirrhosis was associated with an increased risk of stroke, particularly hemorrhagic stroke. A potential explanation of these findings implicates the mixed coagulopathy observed in cirrhosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.