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Evaluating clinical outcomes and prognosis in patients with cirrhosis and portal hypertension: a retrospective observational cohort study. | LitMetric

AI Article Synopsis

  • The study investigates the prognosis of cirrhosis with portal hypertension using a large dataset from electronic health records between 2017 and 2020.
  • It categorizes patients into three severity groups—most severe, moderate severity, and least severe—and analyzes outcomes like variceal hemorrhage, hepatic encephalopathy, complications from ascites, and mortality at 24 months.
  • Findings show a high cumulative incidence of complications and confirm a generally poor prognosis for patients with portal hypertension, with a notable link to alcohol-associated liver disease and metabolic-associated steatohepatitis.

Article Abstract

Objective: Cirrhosis describes the end-stage of chronic liver disease. Irreversible changes in the liver cause portal hypertension, which can progress to serious complications and death. Only a few studies with small sample sizes have investigated the prognosis of cirrhosis with portal hypertension. We used electronic healthcare records to examine liver-related outcomes in patients with diagnosed/suspected portal hypertension.

Design: This retrospective observational cohort study used secondary health data between 1 January 2017 and 3 December 2020 from the TriNetX Network, a federated electronic healthcare records platform. Three patient groups with cirrhosis and diagnosed/suspected portal hypertension were identified ('most severe', 'moderate severity' and 'least severe'). Outcomes studied individually and as a composite were variceal haemorrhage, hepatic encephalopathy, complications of ascites and recorded mortality up to 24 months.

Results: There were 13 444, 23 299, and 23 836 patients in the most severe, moderate severity and least severe groups, respectively. Mean age was similar across groups; most participants were white. The most common individual outcomes at 24 months were variceal haemorrhage in the most severe group, recorded mortality and hepatic encephalopathy in the moderate severity group, and recorded mortality in the least severe group. Recorded mortality rate was similar across groups. For the composite outcome, cumulative incidence was 59% in the most severe group at 6 months. Alcohol-associated liver disease and metabolic-associated steatohepatitis were significantly associated with the composite outcome across groups.

Conclusion: Our analysis of a large dataset from electronic healthcare records illustrates the poor prognosis of patients with diagnosed/suspected portal hypertension.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689413PMC
http://dx.doi.org/10.1136/bmjgast-2023-001234DOI Listing

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