ArticlePloS one2023
Late-stage presentation with decompensated cirrhosis is alarmingly common but successful etiologic therapy allows for favorable clinical outcomes.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- Detection of undiagnosed liver cirrhosis via AI-enabled electrocardiogram: a pragmatic, cluster-randomized clinical trial.Nature medicine · 2026Trial
- An artificial intelligence-augmented electrocardiogram model can detect undiagnosed chronic liver disease, but can this be applied in primary care?Hepatobiliary surgery and nutrition · 2026Article
- Reduced wait times for hepatology referrals in a prospective quality improvement initiative.Hepatology communications · 2026Article
- Comparative Risk of Recurrent Esophageal Variceal Hemorrhage and Other Decompensation Events with Carvedilol Versus Propranolol in Patients with Cirrhosis: A Retrospective Study.Digestive diseases and sciences · 2026Article
- Alcohol Use After TIPS Implantation Significantly Increases the Risk of ACLF and Liver-Related Death.United European gastroenterology journal · 2026Article
- Wilson's Disease in Oman: A National Cohort Study of Clinical Spectrum, Diagnostic Delay, and Long-Term Outcomes.Clinics and practice · 2025Article
- Validation of ICD-10 Consensus Code Set for Cirrhosis Detection Using Electronic Health Records in an Asian Population.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Risk factors and prognostic impact of new decompensated events in hospitalized patients with decompensated cirrhosis.BMC gastroenterology · 2024Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLiver cirrhosis accounts for considerable morbidity and mortality worldwide and late presentation limits therapeutic options. We aimed to assess characteristics of patients with liver cirrhosis at the time of first presentation and during their clinical course.
methodsPatients with cirrhosis as evident by presence of varices at endoscopy, liver stiffness ≥15kPa at elastography, or ascites requiring paracentesis between Q1/2015-Q2/2020 were retrospectively included. Clinical, laboratory, and imaging data were collected from medical records at presentation and last follow-up.
results476 patients were included (alcohol-related liver disease, ALD: 211, 44.3%; viral hepatitis: 163, 34.2%). Of these, 106 patients (22.3%) and 160 patients (33.6%) presented already with Child-Pugh C and MELD >15, respectively, and decompensation events were registered in 50% (238 patients) at baseline, and even in 75.4% of ALD patients. During a median follow-up of 11.0 (IQR 4-24) months, 116 patients died. Two-year survival was worse for patients with ALD than for viral hepatitis (71.1% vs. 90.2%, log rank p<0.001). We observed the highest percentage of portal-vein thrombosis (30.0%), hepatocellular carcinoma (15.0%), and death (45.0%) in the MAFLD group (n = 20). Patients cured from hepatitis C showed significant improvements in platelet count (147 to 169 G/L, p<0.001) and liver stiffness (26.2 to 17.7 kPa, p<0.001), while ALD patients improved in Child-Pugh score (8.6 to 7.6, p<0.001) during follow-up. With increasing Child Pugh score and MELD, we found increasing serum concentrations of CRP (p<0.001) and an inverse correlation with serum HDL (Spearman's ρ = -0.573 and -0.529, respectively, p<0.001).
conclusionHalf of the patients with cirrhosis had decompensated cirrhosis at presentation. This calls for increased awareness and strategies for earlier diagnosis of chronic liver disease and cirrhosis.
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