ArticleUnited European gastroenterology journal2025
Decline in Complications and Mortality in Chronic Liver Disease and Cirrhosis: A Population-Based Cohort Study From Northeastern Italy.
Article in United European gastroenterology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Decline in Complications and Mortality in Chronic Liver Disease and Cirrhosis: A Population-Based Cohort Study From Northeastern Italy.United European gastroenterology journal · 2025Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent trends in complications and mortality among individuals with chronic liver disease and cirrhosis are largely unknown.
objectiveTo explore changes in mortality trends among patients with cirrhosis and chronic liver disease based on etiology in the Veneto Region (Italy), to differentiate mortality between liver-related and non-liver-related causes before and during the COVID-19 pandemic, and to determine trends in the development of cirrhosis complications.
methodsThree subsequent population-based cohorts of individuals with chronic liver disease/cirrhosis were identified in Veneto (North-eastern Italy, 4.9 million residents): the first enrolled before introduction of direct-acting antivirals (DAA); the second corresponding to full availability of DAA treatment; and the last enrolled at the beginning of the pandemic. Risks of liver decompensation and death-liver and non-liver related-were recorded for each cohort during a 3-year follow-up. Changes in the risk of death across cohorts were measured by risk ratios (RR) obtained through Poisson regression models with robust error variance.
resultsAcross the cohorts spanning over 10 years, we found that the number of individuals with CLD and cirrhosis remained stable at about 40,000 and 10,000, respectively. The 3-year risk of ascites, hepatic encephalopathy, and hepatocellular carcinoma decreased across the study period, largely due to individuals with HCV-related liver disease. The overall 3-year mortality risk declined by 14% (liver cirrhosis, subjects enrolled in 2020 vs. 2013: RR = 0.86, 95% CI 0.83-0.89), especially among those with viral etiology. In contrast, mortality due to alcohol-related chronic liver disease/cirrhosis was stable or increasing during the COVID-19 pandemic, especially for non-liver causes of death.
conclusionsDespite increased awareness and proactive enrollment into patient care, chronic liver disease and cirrhosis remain significant health-challenges. The reduction in HCV-related mortality underscores the impact of antiviral treatments, while the persistently high mortality risk of alcohol-related disease highlights the need for targeted interventions.
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