Evidence map›Paper›PMID 40998257›Full record

ArticleThe journal of allergy and clinical immunology. In practice2025

Hepatic Manifestations in Common Variable Immunodeficiency Associated With Mortality and Worse Hospital Outcomes in Nationwide Analysis Using National Readmission Database.

Ahmed Elmoursi, Daniel V DiGiacomo, Jocelyn R Farmer, Sara Barmettler

Abstract read
In one paragraph

Article in The journal of allergy and clinical immunology. In practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
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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

4 authors.

Ahmed ElmoursiDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
Daniel V DiGiacomoDepartment of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ.
Jocelyn R FarmerClinical Immunodeficiency Program of Beth Israel Lahey Health, Division of Allergy and Immunology, Lahey Hospital & Medical Center, Burlington, Mass.
Sara BarmettlerDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass. Electronic address: sbarmettler@mgh.harvard.edu.

Funding

Underdiagnosis of primary immunodeficiency disorders: Recognize and EducateR01MD017816 · NIMHD · HARVARD PILGRIM HEALTH CARE, INC. · PI Jocelyn R Farmer, Mei-Sing Ong · 2022 to 2026
$3.2M
Modeling Risk for Hypogammaglobulinemia, Infections, and Mortality with Chimeric Antigen Receptor (CAR) T-cell TherapyK23AI163350 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI BARMETTLER, SARA · 2021 to 2025
$1.1M
NIAID NIH HHS K23 AI163350NIMHD NIH HHS R01 MD017816
6 · The paper itself

Abstract

backgroundLiver disease is associated with increased mortality in patients with common variable immunodeficiency (CVID), yet we lack population-level data on its impact on CVID-associated hospitalizations in the United States.

objectiveTo conduct a nationwide analysis evaluating the prevalence, spectrum, clinical correlates, and outcomes of hepatic manifestations among admitted adults with CVID.

methodsWe performed a retrospective cross-sectional analysis using the National Readmission Database, part of the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality. International Classification of Diseases, Tenth Revision codes were used to assess hepatic complications, comorbidities, risk factors, and outcomes in CVID-associated admissions with liver involvement.

resultsOf 181,288 CVID-related index hospitalizations, 10% (18,823) had a codiagnosed hepatic complication, specifically hepatic steatosis (38%), cirrhosis (24%), nonalcoholic fatty liver disease (17%), portal hypertension (15%), and nodular regenerative hyperplasia (14%). CVID-associated admissions with hepatic disease had longer median lengths of stay (7 vs 5 days, P < .0001), higher in-hospital mortality (11% vs 4%, P < .0001), and higher median hospital charges ($68,114 vs $44,757, P < .0001). They also had a higher prevalence of hypertension, chronic kidney disease, diabetes, obesity, and autoimmune cytopenia (P < .0001 for all). Alcohol use, hepatitis C, and hepatitis B were strong predictors of hepatic manifestations in CVID admissions (P < .0001). Patients with CVID with nodular regenerative hyperplasia (hazard ratio, 1.3; 95% CI, 1.2-1.5; P < .0001) and portal hypertension (hazard ratio, 1.4; 95% CI, 1.2-1.5; P < .0001) had lower survival.

conclusionsCVID-associated admissions with liver disease, particularly those with nodular regenerative hyperplasia and portal hypertension, were longer, more costly, and associated with increased mortality. Further studies are needed to improve early detection and long-term outcomes.

Indexed as

Common Variable ImmunodeficiencyHospital MortalityLiver DiseasesPatient ReadmissionAdolescentAdultAgedComorbidityCross-Sectional StudiesDatabases, FactualFemaleHealth Care CostsHumansMaleMiddle AgedOutcome Assessment, Health CareCommon variable immunodeficiencyHepatic manifestationsHospital readmissionIn-hospital mortalityLiver diseaseNationwide Readmissions DatabaseNodular regenerative hyperplasiaPortal hypertensionPrimary immunodeficiency

Identifiers

PMID40998257
PMCPMC12862593

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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.