Male Sex Is Associated With Higher Rates of Liver‐Related Mortality in Primary Biliary Cholangitis and Cirrhosis

John, Binu; Aitcheson, Gabriella; Schwartz, Kaley; Khakoo, Nidah S.; Dahman, Bassam; Deng, Yangyang; Goldberg, David S.; Martin, Paul; Taddei, Tamar H.; Levy, Cynthia; Kaplan, David E.

doi:10.1002/hep.31776

Cited by 41 publications

(39 citation statements)

References 27 publications

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“…Interestingly, our results suggested that male gender was an independent risk factor of grade B/C PHLF. This result was similar to the findings noted by John BV and colleagues ( 29 ). The exact mechanisms for the increased prevalence of severe PHLF in men are unclear.…”

Section: Discussionsupporting

confidence: 93%

A Novel Nomogram for Predicting Postoperative Liver Failure After Major Hepatectomy for Hepatocellular Carcinoma

Lei

Cheng

et al. 2022

Front. Oncol.

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BackgroundPost-hepatectomy liver failure (PHLF) is the most common cause of mortality after major hepatectomy in hepatocellular carcinoma (HCC) patients. We aim to develop a nomogram to preoperatively predict grade B/C PHLF defined by the International Study Group on Liver Surgery Grading (ISGLS) in HCC patients undergoing major hepatectomy.Study DesignThe consecutive HCC patients who underwent major hepatectomy at the Eastern Hepatobiliary Surgery Hospital between 2008 and 2013 served as a training cohort to develop a preoperative nomogram, and patients from 2 other hospitals comprised an external validation cohort. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied to identify preoperative predictors of grade B/C PHLF. Multivariable logistic regression was utilized to establish a nomogram model. Internal and external validations were used to verify the performance of the nomogram. The accuracy of the nomogram was also compared with the conventional scoring models, including MELD and ALBI score.ResultsA total of 880 patients who underwent major hepatectomy (668 in the training cohort and 192 in the validation cohort) were enrolled in this study. The independent risk factors of grade B/C PHLF were age, gender, prothrombin time, total bilirubin, and CSPH, which were incorporated into the nomogram. Good prediction discrimination was achieved in the training (AUROC: 0.73) and validation (AUROC: 0.72) cohorts. The calibration curve also showed good agreement in both training and validation cohorts. The nomogram has a better performance than MELD and ALBI score models.ConclusionThe proposed nomogram showed more accurate ability to individually predict grade B/C PHLF after major hepatectomy in HCC patients than MELD and ALBI scores.

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Section: Discussionsupporting

confidence: 93%

A Novel Nomogram for Predicting Postoperative Liver Failure After Major Hepatectomy for Hepatocellular Carcinoma

Lei

Cheng

et al. 2022

Front. Oncol.

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“…Our study included 273 patients with PBC diagnosed per AASLD criteria, of which 89% were female, which is consistent with prior epidemiologic studies 2,[12][13][14][15] . Out of the 273 patients, 172 underwent abdominal ultrasound, 95 underwent helical CT scan, and 129 underwent MRI/MRCP.…”

Section: Discussionsupporting

confidence: 68%

Clinicopathological and Imaging Features of Primary Biliary Cholangitis

Xie¹,

Nyabanga²,

Sehmbhi³

et al. 2022

Preprint

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Abstract/KeywordsBackground and AimsPrimary biliary cholangitis (PBC) is a chronic inflammatory autoimmune disease of the biliary epithelial cells, causing slow progression of cholestasis and fibrosis. The aim of the study is to summarize the imaging features of PBC and examine the correlation between its clinicopathological and radiologic features, elucidating the specific clinicopathological and radiologic differences between male and female PBC patients, as well as between AMA-positive and AMA-negative PBC patients.MethodsDemographic, laboratory, radiologic and survival data were collected retrospectively for patients diagnosed and treated for PBC at the Mount Sinai Health System between 2016 and 2020 with at least one ultrasound, CT, or MRI of abdomen available for assessment. Biochemical and radiologic data were compared between male v.s. female groups, and AMA-positive v.s. AMA-negative group.ResultsA total of 273 patients diagnosed with PBC were included. Non-specific hepatic parenchymal disease, cirrhosis, cholelithiasis, splenomegaly, lymphadenopathy, benign liver masses/cysts were the most common features on abdominal images. 24% of PBC patients had biliary tree abnormalities on MRI. LAD was reported in 38-47% of PBC patients. There was no significant difference in age, race, or ethnicity between the sexes of patients with PBC, however imaging characteristics of portal hypertension were more frequently seen in men. AMA-negative PBC patients had similar distributions of age, race/ethnicity and survival to AMA-positive PBC patients.ConclusionOur study summarized the clinicopathological and imaging features of PBC and distinct subgroups. This would assist in the diagnosis of PBC and avoid over-testing in real-world practice.

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“…The assembly of this cohort has been described. [ 4 , 5 ] In response to the SARS‐CoV‐2 pandemic, the Veterans Administration (VA) created the national VA COVID‐19 Shared Data Resource using case definitions that were validated across the system and including all veterans with a confirmed laboratory diagnosis of SARS‐CoV‐2 infection, both those tested within the VA and outside the VA. Institutional review boards at all participating VA health systems approved the protocol and waived the need for informed consent.…”

Section: Methodsmentioning

confidence: 99%

Postvaccination COVID‐19 infection is associated with reduced mortality in patients with cirrhosis

et al. 2022

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Background and Aims Patients develop breakthrough COVID‐19 infection despite vaccination. The aim of this study was to identify outcomes in patients with cirrhosis who developed postvaccination COVID‐19. Methods We performed a retrospective cohort study among US veterans with cirrhosis and postvaccination or unvaccinated COVID‐19. Patients were considered fully vaccinated if COVID‐19 was diagnosed 14 days after the second dose of either the Pfizer BNT162b2, the Moderna 1273‐mRNA, or the single‐dose Janssen Ad.26.COV2.S vaccines and partially vaccinated if COVID‐19 was diagnosed 7 days after the first dose of any vaccine but prior to full vaccination. We investigated the association of postvaccination COVID‐19 with mortality. Results We identified 3242 unvaccinated and 254 postvaccination COVID‐19 patients with cirrhosis (82 after full and 172 after partial vaccination). In a multivariable analysis of a 1:2 propensity‐matched cohort including vaccinated ( n = 254) and unvaccinated ( n = 508) participants, postvaccination COVID‐19 was associated with reduced risk of death (adjusted HR [aHR], 0.21; 95% CI, 0.11–0.42). The reduction was observed after both full (aHR, 0.22; 95% CI, 0.08–0.63) and partial (aHR, 0.19; 95% CI, 0.07–0.54) vaccination, following the 1273‐mRNA (aHR, 0.12; 95% CI 0.04–0.37) and BNT162b2 (aHR, 0.27; 95% CI, 0.10–0.71) vaccines and among patients with compensated (aHR, 0.19; 95% CI, 0.08–0.45) and decompensated (aHR, 0.27; 95% CI, 0.08–0.90) cirrhosis. Findings were consistent in a sensitivity analysis restricted to participants who developed COVID‐19 after vaccine availability. Conclusions Though patients with cirrhosis can develop breakthrough COVID‐19 after full or partial vaccination, these infections are associated with reduced mortality.

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Male Sex Is Associated With Higher Rates of Liver‐Related Mortality in Primary Biliary Cholangitis and Cirrhosis

Cited by 41 publications

References 27 publications

A Novel Nomogram for Predicting Postoperative Liver Failure After Major Hepatectomy for Hepatocellular Carcinoma

A Novel Nomogram for Predicting Postoperative Liver Failure After Major Hepatectomy for Hepatocellular Carcinoma

Clinicopathological and Imaging Features of Primary Biliary Cholangitis

Postvaccination COVID‐19 infection is associated with reduced mortality in patients with cirrhosis

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