The Epidemiology of Cirrhosis in the United States

Scaglione, Steven; Kliethermes, Stephanie; Cao, Guichan; Shoham, David A.; Durazo, Ramón; Luke, Amy; Volk, Michael L.

doi:10.1097/mcg.0000000000000208

Cited by 586 publications

(498 citation statements)

References 11 publications

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“…We conducted sensitivity analysis to further assess whether there was a consistent increased risk of cirrhosis in first-degree relatives of NAFLD-cirrhosis patients using the estimated prevalence of cirrhosis in the general population in the United States (19,20). The risk of having cirrhosis among first-degree relatives of NAFLD-cirrhosis patients remained significant and was even higher with an OR of 80.85 (95% CI, 32.85-198.99, P < 0.0001) using a prevalence of cirrhosis of 0.27% reported by Shuppan et al (20) and with an OR of 145.63 (95% CI, 55.65-381.06, P < 0.0001) using a prevalence of 0.15% reported by Scaglione et al (19).…”

Section: Resultsmentioning

confidence: 99%

Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis

Caussy¹,

Soni²,

Cui³

et al. 2017

Journal of Clinical Investigation

143

114

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Section: Resultsmentioning

confidence: 99%

Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis

Caussy¹,

Soni²,

Cui³

et al. 2017

Journal of Clinical Investigation

143

114

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“…Most of the Indian studies have showed a predominant alcohol related cirrhosis but studies in western population showed a predominant Hepatitis B and C related cirrhosis. 7,10,12,[13][14][15] Cirrhosis has been postulated to be associated with abnormality of glucose metabolism. This results in a higher prevalence of Diabetes mellitus (DM) in cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

2017

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Background: Peripheral neuropathy is not an uncommon complication of liver cirrhosis but it is not given much clinical relevance. The pattern and prevalence of peripheral neuropathy has also not been studied extensively. Alcohol use, coexisting diseases and nutritional deficiency have been postulated as factors responsible for neuropathy. The aim of this study was to define the pattern and prevalence of neuropathy in cirrhosis and to determine any etiologic correlation.Methods: 85 patients of cirrhosis of liver were studied. Apart from routine investigations, serum vitamin B12 estimation was also done in these patients. Electrophysiological studies were done in 46 patients.Results: Alcohol was the most common etiology of cirrhosis (57.6%). Hepatitis B related (11.8%) and Hepatitis C (4.7%) were other etiologies. The prevalence of peripheral neuropathy by electrophysiological studies was found to be 67.39% in cirrhosis of any etiology, of which 43.5% had sensorimotor type and the predominant pattern of peripheral neuropathy was mixed axonal degeneration and demyelination. The peripheral neuropathy was significantly more (p=0.01) in child class C than other child classes. Prevalence of neuropathy had no significant difference (p=1.00) between alcoholic and non-alcoholic cirrhosis. No correlation was present with either serum vitamin B12 levels or blood glucose levels.Conclusions: Peripheral neuropathy is present in more than half of cirrhosis patients and is unrelated to etiology and nutritional status but related to the severity of cirrhosis.

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“…16 The prevalence of liver cirrhosis is increasing and is estimated to be present in approximately 630,000 adults in the United States. 17 Cirrhotic patients are at an increased risk for developing decompensation related to cirrhosis and portal hypertension, including variceal bleeding, ascites, hepatic encephalopathy, hepato-renal syndrome, spontaneous bacterial peritonitis, and sepsis. Patients with cirrhosis admitted to the ICU have a substantially high mortality rate of 50% to 100%.…”

Section: Prognostic Scoring Systems For Critically Ill Cirrhotic Patimentioning

confidence: 99%

The use of MELD scores in critically ill cirrhotic patients

Rassameehiran

Woreta²

2016

SW Resp Crit Care Chron

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The Model for End-Stage Liver Disease (MELD) was originally created to predict survival following transjugular intrahepatic portosystemic shunt and was subsequently found to accurately predict mortality in patients with end-stage liver disease. It has been used in the United States for liver allocation since 2002, and implementation of the MELD score resulted in a reduction in total number of deaths on the waitlist and a reduction in waiting time. Critically ill cirrhotic patients have an in-hospital mortality greater than 50%. Although the MELD score was also found to be an accurate predictor of in-ICU mortality and in-hospital mortality after ICU admission in critically ill cirrhotic patients, the Sequential Organ Failure Assessment (SOFA) score appears to perform better in many studies. The Chronic Liver Failure Consortium Acute-onChronic Liver Failure (CLIF-C ACLF) score was later developed by using specific cut-points for each organ failure score system in CLIF patients to predict mortality in patients with ACLF. Neither the MELD nor SOFA score independently predicts post-liver transplantation mortality in cirrhotic patients with extrahepatic organ failure and should not be use as a delisting criterion for these patients. More data are needed to determine the accuracy of the CLIF-C ACLF score in predicting post-liver transplantation outcomes. Prospective evaluation of critically ill cirrhotic patients is needed to optimize liver organ allocation.

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The Epidemiology of Cirrhosis in the United States

Cited by 586 publications

References 11 publications

Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis

Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis

Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

The use of MELD scores in critically ill cirrhotic patients

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