Evidence map›Paper›PMID 36650007›Full record

ArticleBMJ open gastroenterology2023

Negative impact of the pandemic on hospital admissions, morbidity and early mortality for acute cirrhosis decompensation.

Kohilan Gananandan, Alexandra Phillips, Anmol Chikhlia, Hannah Old, Sharmaine Jia Ying Sim, Niharika Thakur, Ishrat Hussain, Konstantin Kazankov, Rajeshwar P Mookerjee

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open gastroenterology, 2023. 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
1.0field-weighted citation impact, top 25% 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, 5 citations in OpenAlex.

  1. Article
  2. Where Do Patients With Cirrhosis Die? A CDC WONDER Analysis From 1999 to 2020.JGH open : an open access journal of gastroenterology and hepatology · 2025
    Article
  3. Article
  4. Article
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

9 authors at 3 institutions in 2 countries.

Kohilan GananandanUniversity College London Institute for Liver and Digestive Health, London, UK.ORCID 0000-0003-2781-3354
Alexandra PhillipsUniversity College London Institute for Liver and Digestive Health, London, UK.
Anmol ChikhliaRoyal Free London NHS Foundation Trust, London, UK.
Hannah OldRoyal Free London NHS Foundation Trust, London, UK.
Sharmaine Jia Ying SimUniversity College London Institute for Liver and Digestive Health, London, UK.
Niharika ThakurUniversity College London Institute for Liver and Digestive Health, London, UK.
Ishrat HussainUniversity College London Institute for Liver and Digestive Health, London, UK.ORCID 0000-0002-5281-4028
Konstantin KazankovUniversity College London Institute for Liver and Digestive Health, London, UK.
Rajeshwar P MookerjeeUniversity College London Institute for Liver and Digestive Health, London, UK r.mookerjee@ucl.ac.uk.
University College London · GBAarhus University Hospital · DKRoyal Free London NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe global pandemic has diverted resources away from management of chronic diseases, including cirrhosis. While there is increasing knowledge on COVID-19 infection in liver cirrhosis, little is described on the impact of the pandemic on decompensated cirrhosis admissions and outcomes, which was the aim of this study.

methodsA single-centre, retrospective study, evaluated decompensated cirrhosis admissions to a tertiary London hepatology and transplantation centre, from October 2018 to February 2021. Patients were included if they had an admission with cirrhosis decompensation defined as new-onset jaundice or ascites, infection, encephalopathy, portal hypertensive bleeding or renal dysfunction.

resultsThe average number of admissions stayed constant between the pre-COVID-19 (October 2018-February 2020) and COVID-19 periods (March 2020-February 2021). Patients transferred in from secondary centres had consistently higher severity scores during the COVID-19 period (UK Model for End-Stage Liver Disease 58 vs 54; p=0.007, Model for End-Stage Liver Disease-Sodium 22 vs 18; p=0.006, EF-CLIF Acute Decompensation (AD) score 55.0 vs 51.0; p=0.055). Of those admitted to the intensive care without acute-on-chronic liver failure, there was a significant increase in AD scores during the COVID-19 period (58 vs 48, p=0.009). In addition, there was a trend towards increased hospital readmission rates during the COVID-19 period (29.5% vs 21.5%, p=0.067). When censored at 30 days, early mortality postdischarge was significantly higher during the COVID-19 period (p<0.001) with a median time to death of 35 days compared with 62 days pre-COVID-19. DISCUSSION: This study provides a unique perspective on the impact that the global pandemic had on decompensated cirrhosis admissions. The findings of increased early mortality and readmissions, and higher AD scores on ICU admission, highlight the need to maintain resourcing for high-level hepatology care and follow-up, in spite of other disease pressures.

Indexed as

COVID-19End Stage Liver DiseaseAftercareHospitalsHumansLiver CirrhosisMorbidityPandemicsPatient DischargeRetrospective StudiesSeverity of Illness Indexchronic liver diseaseCOVID-19liver cirrhosis

Identifiers

PMID36650007
PMCPMC9853150
OpenAlexW4317207472

What OpenQuestion holds

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LicenceCC BY-NC
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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.