Liver-related mortality is similar among men and women with cirrhosis

Mazumder, Nikhilesh; Celaj, Stela; Atiemo, Kofi; Daud, Amna; Jackson, Kathryn; Kho, Abel N.; Levitsky, Josh; Ladner, Daniela P.

doi:10.1016/j.jhep.2020.04.022

Cited by 23 publications

(20 citation statements)

References 40 publications

(67 reference statements)

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“…Similarly, for liver cirrhosis a negative effect on survival was found only in men, although it was diagnosed with equal frequency in men and women. One possible reason could be that women with cirrhosis tend to have fewer complications of this disease and lower rates of hepatocellular carcinoma 49 .…”

Section: Discussionmentioning

confidence: 99%

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

Trudzinski

Jörres

Alter

et al. 2022

Sci Rep

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In patients with COPD, it has not been comprehensively assessed whether the predictive value of comorbidities for mortality differs between men and women. We therefore aimed to examine sex differences of COPD comorbidities in regard with prognosis by classifying comorbidities into a comorbidome related to extrapulmonary disorders and a pulmorbidome, referring to pulmonary disorders. The study population comprised 1044 women and 1531 men with the diagnosis of COPD from COSYCONET, among them 2175 of GOLD grades 1–4 and 400 at risk. Associations of comorbidities with mortality were studied using Cox regression analysis for men and women separately. During the follow-up (median 3.7 years) 59 women and 159 men died. In men, obesity, hypertension, coronary artery disease, liver cirrhosis, osteoporosis, kidney disease, anaemia and increased heart rate (HR) predict mortality, in women heart failure, hyperuricemia, mental disorders, kidney disease and increased HR (p < 0.05 each). Regarding the pulmorbidome, significant predictors in men were impairment in diffusion capacity and hyperinflation, in women asthma and hyperinflation. Similar results were obtained when repeating the analyses in GOLD 1–4 patients only. Gender differences should be considered in COPD risk assessment for a tailored approach towards the treatment of COPD.Clinical Trial Registration: ClinicalTrials.gov NCT01245933.

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Section: Discussionmentioning

confidence: 99%

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

Trudzinski

Jörres

Alter

et al. 2022

Sci Rep

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show abstract

“…Although a global population study concluded that among the population below 70 years, males had a higher prevalence of cirrhosis and several DALYs (Disability-Adjusted Life Years) because of liver disease [38]. In the US, women seem to have a higher prevalence of NASH-related cirrhosis than males, both compensated and decompensated [32,39]. Little has been studied about gender/sex differences in NAFLD progression to advanced fibrosis; however, it seems that the prevalence of advanced fibrosis is similar (OR 1.6 vs. 1.4) when only postmenopausal women are analyzed [40].…”

Section: Advanced Liver Disease In Nafld Gender/sexmentioning

confidence: 99%

What Do We Know about Inequalities in NAFLD Distribution and Outcomes? A Scoping Review

Talens

Tumas

Lazarus

et al. 2021

JCM

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With prevalence high and rising given the close relationship with obesity and diabetes mellitus, non-alcoholic fatty liver disease (NAFLD) is progressively becoming the most common chronic liver condition worldwide. However, little is known about the health inequalities in NAFLD distribution and outcomes. This review aims to analyze health inequalities in NAFLD distribution globally and to assess the health disparities in NAFLD-related outcomes. We conducted a scoping review of global health inequalities in NAFLD distribution and outcomes according to gender/sex, ethnicity/race, and socioeconomic position from PubMed’s inception to May 2021. Ultimately, 20 articles were included in the review, most (75%) of them carried out in the United States. Males were found to have a higher NAFLD prevalence (three articles), while available evidence suggests that women have an overall higher burden of advanced liver disease and complications (four articles), whereas they are less likely to be liver-transplanted once cirrhosis develops (one article). In the US, the Hispanic population had the highest NAFLD prevalence and poorer outcomes (seven articles), whereas Whites had fewer complications than other ethnicities (two articles). Patients with low socioeconomic status had higher NAFLD prevalence (four articles) and a higher likelihood of progression and complications (five articles). In conclusion, globally there is a lack of studies analyzing NAFLD prevalence and outcomes according to various axes of inequality through joint intersectional appraisals, and most studies included in our review were based on the US population. Available evidence suggests that NAFLD distribution and outcomes show large inequalities by social group. Further research on this issue is warranted.

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“…In relation to sex disparity in LT, fewer women than men received LT in our cohort, which is consistent with other studies [ 26 , 27 ]. It remains controversial whether there are sex differences in post-LT survival, with recent large studies finding no difference after adjusting for graft quality [ 28 , 29 ]. Multiple studies have shown women to be at higher risk of mortality or of becoming too unwell for transplantation while on the waitlist [ 26 , 27 , 30 , 31 ], and a single center study by Rubin et al found that women on the transplant waitlist had higher levels of hospitalization than men [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Prognostic Significance of Rapid Response System Activation in Patients Undergoing Liver Transplantation

Robertson

Lim

Bloom

et al. 2021

JCM

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Patients undergoing liver transplantation have a high risk of perioperative clinical deterioration. The Rapid Response System is an intensive care unit-based approach for the early recognition and management of hospitalized patients identified as high-risk for clinical deterioration by a medical emergency team (MET). The etiology and prognostic significance of clinical deterioration events is poorly understood in liver transplant patients. We conducted a cohort study of 381 consecutive adult liver transplant recipients from a prospectively collected transplant database (2011–2017). Medical records identified patients who received MET activation pre- and post-transplantation. MET activation was recorded in 131 (34%) patients, with 266 MET activations in total. The commonest triggers for MET activation were tachypnea and hypotension pre-transplantation, and tachycardia post-transplantation. In multivariable analysis, female sex, increasing Model for End-Stage Liver Disease score and hepatorenal syndrome were independently associated with MET activation. The unplanned intensive care unit admission rate following MET activation was 24.1%. Inpatient mortality was 4.2% and did not differ by MET activation status; however, patients requiring MET activation had significantly longer intensive care unit and hospital length of stay and were more likely to require inpatient rehabilitation. In conclusion, liver transplant patients with perioperative complications requiring MET activation represent a high-risk group with increased morbidity and length of stay.

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Liver-related mortality is similar among men and women with cirrhosis

Cited by 23 publications

References 40 publications

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

What Do We Know about Inequalities in NAFLD Distribution and Outcomes? A Scoping Review

Epidemiology and Prognostic Significance of Rapid Response System Activation in Patients Undergoing Liver Transplantation

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