ArticleThe Lancet regional health. Europe2022
Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018).
Article in The Lancet regional health. Europe, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06523608 (Prediction of Decompensation and HCC Development in Patients With Advanced Chronic Liver Disease by the PLEASE and M10S20 Algorithms), which is not on this map. Cited by 59 papers, 1 of them a synthesis that pooled it.
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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.
Prediction of Decompensation and HCC Development in Patients With Advanced Chronic Liver Disease by the PLEASE and M10S20 Algorithms
Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 152 citations in OpenAlex.
- The impact of food insecurity on chronic liver disease: A systematic review of the literature.Hepatology communications · 2025Pooled it
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- Contemporary global epidemiology of cirrhosis.Hepatology communications · 2026Review
- Managing Coagulation Abnormalities, Bleeding, and Thrombosis in Patients with Cirrhosis.Journal of general internal medicine · 2026Review
- Lack of association between rifaximin and drug-resistant infections: a global multicenter inpatient cirrhosis cohort.Clinical and molecular hepatology · 2026Article
- [Detection and differentiation of atypical hepatocellular carcinomas].Radiologie (Heidelberg, Germany) · 2026Article
- Comparative performance of ReMELD-Na, MELD 3.0 and established scores after TIPS for refractory ascites: A multicenter study.JHEP reports : innovation in hepatology · 2026Article
- Hospitalization Trends Due to Chronic Liver Diseases: Vicious Circle of Co-Morbidities and Hospitalization Length.Clinics and practice · 2026Article
- Same Session Validation of a Custom-Built 22G With the Commercial 25G System for EUS-Guided Portal Pressure Gradient Measurement.United European gastroenterology journal · 2026Article
- MetALD: decoding the evolution of steatotic liver disease nomenclature and implications for clinical practice and beyond.Gastroenterology report · 2026Review
- Impact of Frailty on the Prognosis of Patients With Liver Cirrhosis Undergoing Insertion of a TIPS.Alimentary pharmacology & therapeutics · 2026Observational
- Emerging Trends in Patients Hospitalised With Cirrhosis-Aetiologies, Complications and Outcomes Compared to Other Chronic Health Conditions.Alimentary pharmacology & therapeutics · 2025Article
- Article
- Evaluating thresholds of Mac-2 binding protein glycosylation isomer in association with clinical outcomes in patients with cirrhosis.World journal of hepatology · 2025Article
- A population-based study of cause-specific mortality in First Nations Australians with cirrhosis: impact of cardiometabolic comorbidities and liver disease risk factors.The Lancet regional health. Western Pacific · 2025Article
- The prognostic significance of HDL-associated apolipoproteins in ascitic fluid from patients with cirrhosis and spontaneous bacterial peritonitis.Scientific reports · 2025Article
- Review
- Vitamin D Deficiency and Chronic Liver Disease: Investigating Predictive Factors and Their Implications for Patient Care in Pakistan.Iranian journal of public health · 2025Article
- The steatotic liver disease burden paradox: unravelling the key role of alcohol.Nature reviews. Gastroenterology & hepatology · 2025Review
- The clinical relevance of acute-on-chronic liver failure in medical procedures: Endoscopy, interventions and surgery.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
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Authors and funding
19 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCirrhosis is known to have a high prevalence and mortality worldwide. However, in Europe, the epidemiology of cirrhosis is possibly undergoing demographic changes, and etiologies may have changed due to improvements in standard of care. The aim of this population-based study was to analyze the trends and the course of liver cirrhosis and its complications in recent years in Germany.
methodsWe analyzed the data of all hospital admissions in Germany within diagnosis-related groups from 2005 to 2018. The diagnostic records of cirrhosis and other categories of diseases were based on ICD-10-GM codes. The primary outcome measurement was in-hospital mortality. Trends were analyzed through Poisson regression of annual number of admissions. The impact of cirrhosis on overall in-hospital mortality were assessed through the multivariate multilevel logistic regression model adjusted for age, sex, and comorbidities.
findingsOf the 248,085,936 admissions recorded between 2005 and 2018, a total of 2,302,171(0•94%) were admitted with the diagnosis of cirrhosis, mainly as a comorbidity. Compared with other chronic diseases, patients admitted with cirrhosis were younger, mainly male and had the highest in-hospital mortality rate. Diagnosis of cirrhosis was an independent risk factor of in-hospital mortality with the highest odds ratio (OR:6•2[95%CI:6.1-6•3]) among all diagnoses. The prevalence of non-alcoholic fatty liver disease has increased four times from 2005 to 2018, while alcoholic cirrhosis is 20 times than other etiologies. Bleeding was found to be decreasing over time, but ascites remained the most common complication and was increasing.
interpretationThis nationwide study demonstrates that cirrhosis represents a considerable healthcare burden, as shown by the increasing in-hospital mortality, also in combination with other chronic diseases. Alcohol-related cirrhosis and complications are on the rise. More resources and better management strategies are warranted.
fundingThe funders had no influence on this study.
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