Evidence map›Paper›PMID 34041467›Full record

ArticleJHEP reports : innovation in hepatology2021

A nationwide population-based prospective study of cirrhosis in Iceland.

Sigurdur Olafsson, Sigurjon Rögnvaldsson, Ottar M Bergmann, Jon G Jonasson, Ubaldo Benitez Hernandez, Einar S Björnsson

Open access · goldAbstract read
In one paragraph

Article in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. [Proportion and clinical characteristics of probable metabolic-associated fatty liver disease-related cirrhosis in cryptogenic cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Article
  2. Article
  3. Article
  4. [Vaccination against hepatitis B as prevention for hepatocellular carcinoma].Der Onkologe : Organ der Deutschen Krebsgesellschaft e.V · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Sigurdur OlafssonDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland.
Sigurjon RögnvaldssonDepartment of Surgery, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland.
Ottar M BergmannDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland.
Jon G JonassonFaculty of Medicine, University of Iceland, Reykjavik, Iceland.
Ubaldo Benitez HernandezDepartment of Science/Biostatistics, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland.
Einar S BjörnssonDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland.
National University Hospital of Iceland · ISUniversity of Iceland · IS

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsThe incidence of cirrhosis in Iceland has been the lowest in the world with only 3 cases per 100,000 inhabitants. Alcohol consumption has almost doubled in Iceland from 1980 to 2016. Obesity has also risen and hepatitis C virus has spread among people who inject drugs in Iceland. The aim of this study was to evaluate the effects of these risk factors on the incidence and aetiology of cirrhosis in Iceland.

methodsThe study included all patients diagnosed with cirrhosis for the first time during 2010-2015. Diagnosis was based on liver histology or 2 of 4 criteria: cirrhosis on imaging, ascites, varices, and/or elevated INR.

resultsOverall, 157 patients were diagnosed, 105 (67%) males, mean age 61 years. The overall incidence was 9.7 cases per 100,000 inhabitants annually. Alcohol was the only underlying cause in 48/157 (31%), non-alcoholic fatty liver disease (NAFLD) in 34/157(22%), and alcohol and hepatitis C together in 23/157(15%) were the most common causes. Only 6% of patients had an unknown cause of cirrhosis. Upon diagnosis, the median model for end-stage liver disease score was 11 (IQR 8-15), 53% were of Child-Pugh class A whereas 61 (39%) had ascites, 11% encephalopathy, and 8% variceal bleeding. In all, 25% of deaths were from HCC and 25% from liver failure.

conclusionA major increase in incidence of cirrhosis has occurred in Iceland associated with increases in alcohol consumption, obesity, and hepatitis C. In a high proportion NAFLD was the aetiology and very few had unknown cause of cirrhosis. The highest death rate was from HCC. LAY SUMMARY: In a nationwide population-based study from Iceland, including all patients diagnosed with cirrhosis of the liver over a period of 5 years, we found the incidence of new cases had increased 3-fold compared with a previous study 20 years ago. The increase is attributable to increased alcohol consumption, an epidemic of diabetes and obesity, and infection with the hepatitis C virus. Furthermore, we found that with thorough investigations, a specific cause for cirrhosis could be found in 94% of patients. Patients with cirrhosis frequently die of liver cancer and other complications related to their liver disease.

Indexed as

Aetiology of cirrhosisAIH, autoimmune hepatitisAlcoholALD, alcoholic liver diseaseCIF, cumulative incidence functionCirrhosisCRR, competing-risks regressionHCC, hepatocellular carcinomaHepatitis CIncidence of cirrhosisMELD, model for end-stage liver diseaseNAFLDNAFLD, non-alcoholic fatty liver diseaseNALD, non-alcoholic liver diseaseNASH, non-alcoholic steatohepatitisPBC, primary biliary cirrhosisPSC, primary sclerosing cholangitisSHRs, subhazard ratios

Identifiers

PMID34041467
PMCPMC8141932
OpenAlexW3145769256

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.