ArticlePloS one2022
Mortality burden due to liver cirrhosis and hepatocellular carcinoma in Ghana; prevalence of risk factors and predictors of poor in-hospital survival.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Prevalence of hepatitis C viral infection in Ghana: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- The Economic Impact of Cirrhosis and Other Chronic Liver Diseases on Global, Regional, and National Economies.Clinical and translational gastroenterology · 2026Article
- Predicting short-term mortality in severe cirrhosis: An interpretable machine learning model integrating routine clinical indicators.PloS one · 2026Article
- Hepatocellular Carcinoma in Africa: Epidemiology, Prevention and Outcomes.Current hepatology reports · 2026Review
- Seroprevalence and Determinants of Hepatitis B and C Viral Infections Among Pregnant Women Attending Debark General Hospital, Northwest Ethiopia.BioMed research international · 2026Article
- Suboptimal immunity of hepatitis B vaccination and seroprotection among healthcare professionals in a tertiary hospital in Ghana.Scientific reports · 2025Article
- Prevalence of Hepatitis C viral infection in Ghana: A systematic review and meta-analysis protocol.PloS one · 2025Article
- Predictors of in-hospital mortality among cirrhotic patients in Ethiopia: A multicenter retrospective study.PloS one · 2025Observational
- A Novel Scoring System for Assessing In-Hospital Mortality Risk in Patients With Liver Cirrhosis.Cureus · 2024Article
- Host cytokine genetic polymorphisms in a selected population of persons living with hepatitis B virus infection in the central region of Ghana.BMC gastroenterology · 2024Article
- Development of a predictive nomogram for in-hospital death risk in multimorbid patients with hepatocellular carcinoma undergoing Palliative Locoregional Therapy.Scientific reports · 2024Article
- Transcriptomic and metabolomic analyses reveal the spatial role of carnitine metabolism in the progression of hepatitis B virus cirrhosis to hepatocellular carcinoma.Frontiers in microbiology · 2024Article
- A new cirrhotic animal protocol combining carbon tetrachloride with methotrexate to address limitations of the currently used chemical-induced models.Frontiers in pharmacology · 2023Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Liver-related diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), are significant causes of mortality globally. Specific causes and predictors of liver-related mortality in low resource settings require assessment to help inform clinical decision making and develop strategies for improved survival. The objectives of this study were to determine the proportion of liver-related deaths associated with liver cirrhosis, HCC, and their known risk factors, and secondly to determine predictors of in-hospital mortality among cirrhosis and HCC patients in Ghana. We first performed a cross-sectional review of death register entries from 11 referral hospitals in Ghana to determine the proportion of liver-related deaths and the proportion of risk factors associated with these deaths. Secondly, we conducted a retrospective cohort review of 172 in-patient liver cirrhosis and HCC cases admitted to a tertiary referral centre and determined predictors of in-hospital mortality using binary logistic regression and Kaplan-Meier survival analysis. In total, 8.8% of deaths in Ghanaian adults were due to liver-related causes. The proportion of liver-related deaths attributed to HBV infection was 48.8% (95% CI: 45.95-51.76), HCV infection was 7.0% (95% CI: 5.58-8.45), HBV-HCV co-infection 0.5% (95% CI: 0.1-0.9) and alcohol was 10.0% (95% CI: 8.30-11.67). Of 172 cases of HCC and liver cirrhosis, the in-patient mortality rate was 54.1%. Predictors of in-patient mortality in cirrhotic patients were increasing WBC (OR = 1.14 95% CI: 1.00-1.30) and the revised model for end-stage liver disease with sodium (MELD-Na) score (OR = 1.24 95% CI: 1.01-1.54). For HCC patients, female sex (OR = 3.74 95% CI: 1.09-12.81) and hepatic encephalopathy (grade 1) were associated with higher mortality (OR = 5.66 95% CI: 1.10-29.2). In conclusion, HBV is linked to a high proportion of HCC-related deaths in Ghana, with high in-hospital mortality rates that require targeted policies to improve survival.
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