{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T21:43:09Z","timestamp":1794606189419,"version":"4.9.1"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Liver cirrhosis accounts for considerable morbidity and mortality worldwide and late presentation limits therapeutic options. We aimed to assess characteristics of patients with liver cirrhosis at the time of first presentation and during their clinical course.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients with cirrhosis as evident by presence of varices at endoscopy, liver stiffness \u226515kPa at elastography, or ascites requiring paracentesis between Q1\/2015-Q2\/2020 were retrospectively included. Clinical, laboratory, and imaging data were collected from medical records at presentation and last follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>476 patients were included (alcohol-related liver disease, ALD: 211, 44.3%; viral hepatitis: 163, 34.2%). Of these, 106 patients (22.3%) and 160 patients (33.6%) presented already with Child-Pugh C and MELD &gt;15, respectively, and decompensation events were registered in 50% (238 patients) at baseline, and even in 75.4% of ALD patients.<\/jats:p>\n<jats:p>During a median follow-up of 11.0 (IQR 4\u201324) months, 116 patients died. Two-year survival was worse for patients with ALD than for viral hepatitis (71.1% vs. 90.2%, log rank p&lt;0.001). We observed the highest percentage of portal-vein thrombosis (30.0%), hepatocellular carcinoma (15.0%), and death (45.0%) in the MAFLD group (n = 20). Patients cured from hepatitis C showed significant improvements in platelet count (147 to 169 G\/L, p&lt;0.001) and liver stiffness (26.2 to 17.7 kPa, p&lt;0.001), while ALD patients improved in Child-Pugh score (8.6 to 7.6, p&lt;0.001) during follow-up. With increasing Child Pugh score and MELD, we found increasing serum concentrations of CRP (p&lt;0.001) and an inverse correlation with serum HDL (Spearman\u2019s \u03c1 = -0.573 and -0.529, respectively, p&lt;0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Half of the patients with cirrhosis had decompensated cirrhosis at presentation. This calls for increased awareness and strategies for earlier diagnosis of chronic liver disease and cirrhosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0290352","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T17:30:52Z","timestamp":1692898252000},"page":"e0290352","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Late-stage presentation with decompensated cirrhosis is alarmingly common but successful etiologic therapy allows for favorable clinical outcomes"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2587-1385","authenticated-orcid":true,"given":"Michael","family":"Schwarz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7762-7483","authenticated-orcid":true,"given":"Caroline","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Burghart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"Pfisterer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-8518","authenticated-orcid":true,"given":"David","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"H\u00fcbl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gschwantler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":true,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"pone.0290352.ref001","doi-asserted-by":"crossref","first-page":"k2817","DOI":"10.1136\/bmj.k2817","article-title":"Mortality due to cirrhosis and liver cancer in the United States, 1999\u20132016: observational study","volume":"362","author":"E. B. Tapper","year":"2018","journal-title":"BMJ"},{"issue":"3","key":"pone.0290352.ref002","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S2468-1253(19)30349-8","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"5","author":"S. G. Sepanlou","year":"2020","journal-title":"The Lancet Gastroenterology & Hepatology"},{"issue":"3","key":"pone.0290352.ref003","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.jhep.2012.12.005","article-title":"The burden of liver disease in Europe: a review of available epidemiological data","volume":"58","author":"M. 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Pugh","year":"1973","journal-title":"Br J Surg"},{"issue":"3","key":"pone.0290352.ref030","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1002\/hep.21563","article-title":"The model for end-stage liver disease (MELD)","volume":"45","author":"G. Advanced Liver Disease Study","year":"2007","journal-title":"Hepatology"},{"key":"pone.0290352.ref031","article-title":"Changes to OPTN Bylaws and Policies from actions at OPTN\/UNOS Executive Committee Meetings July 2015-November 2015.","author":"United Network for Organ Sharing (UNOS).","year":"2015"},{"issue":"1","key":"pone.0290352.ref032","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ypmed.2003.11.011","article-title":"Derivation of tolerable upper alcohol intake levels in Germany: a systematic review of risks and benefits of moderate alcohol consumption","volume":"39","author":"M. Burger","year":"2004","journal-title":"Prev Med"},{"key":"pone.0290352.ref033","article-title":"Handbuch Alkohol\u2014\u00d6sterreich 2022: Band 1","author":"Austrian Ministry of Health Care","year":"2022"},{"issue":"1","key":"pone.0290352.ref034","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/hep.22341","article-title":"Comorbidity and survival of Danish cirrhosis patients: a nationwide population-based cohort study","volume":"48","author":"P. Jepsen","year":"2008","journal-title":"Hepatology"},{"issue":"5","key":"pone.0290352.ref035","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1002\/hep.23500","article-title":"Clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study","volume":"51","author":"P. Jepsen","year":"2010","journal-title":"Hepatology"},{"issue":"8","key":"pone.0290352.ref036","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/j.cgh.2016.04.009","article-title":"Rates of and Reasons for Hospital Readmissions in Patients With Cirrhosis: A Multistate Population-based Cohort Study","volume":"14","author":"E. B. Tapper","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"pone.0290352.ref037","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1053\/j.gastro.2018.05.032","article-title":"Increasing Health Care Burden of Chronic Liver Disease Compared With Other Chronic Diseases, 2004\u20132013","volume":"155","author":"S. K. Asrani","year":"2018","journal-title":"Gastroenterology"},{"issue":"1","key":"pone.0290352.ref038","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/s41395-018-0365-4","article-title":"Trends in Chronic Liver Disease-Related Hospitalizations: A Population-Based Study","volume":"114","author":"S. K. Asrani","year":"2019","journal-title":"Am J Gastroenterol"},{"issue":"2","key":"pone.0290352.ref039","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1007\/s10620-017-4749-x","article-title":"Direct-Acting Antiviral Therapy for Chronic HCV Infection Results in Liver Stiffness Regression Over 12 Months Post-treatment","volume":"63","author":"J. Chan","journal-title":"Digestive Diseases and Sciences"},{"issue":"1","key":"pone.0290352.ref040","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.cgh.2017.04.038","article-title":"Magnitude and Kinetics of Decrease in Liver Stiffness After Antiviral Therapy in Patients With Chronic Hepatitis C: A Systematic Review and Meta-analysis","volume":"16","author":"S. Singh","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"pone.0290352.ref041","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1053\/j.gastro.2016.09.009","article-title":"Eradication of Hepatitis C Virus Infection in Patients With Cirrhosis Reduces Risk of Liver and Non-Liver Complications","volume":"152","author":"P. Nahon","year":"2017","journal-title":"Gastroenterology"},{"issue":"3","key":"pone.0290352.ref042","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1002\/hep.30885","article-title":"Changes in Hepatic Venous Pressure Gradient Predict Hepatic Decompensation in Patients Who Achieved Sustained Virologic Response to Interferon-Free Therapy","volume":"71","author":"M. Mandorfer","year":"2020","journal-title":"Hepatology"},{"issue":"10179","key":"pone.0290352.ref043","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(18)32111-1","article-title":"Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study","volume":"393","author":"F. Carrat","year":"2019","journal-title":"The Lancet"},{"issue":"4","key":"pone.0290352.ref044","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.jhep.2021.11.025","article-title":"HCC risk stratification after cure of hepatitis C in patients with compensated advanced chronic liver disease","volume":"76","author":"G. Semmler","year":"2022","journal-title":"J Hepatol"},{"issue":"1","key":"pone.0290352.ref045","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1002\/hep.28535","article-title":"Risk of hepatocellular carcinoma after sustained virological response in Veterans with hepatitis C virus infection","volume":"64","author":"H. B. El-Serag","year":"2016","journal-title":"Hepatology"},{"issue":"11","key":"pone.0290352.ref046","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1111\/liv.14203","article-title":"Platelet count increases after viral elimination in chronic HCV, independent of the presence or absence of cirrhosis","volume":"39","author":"M. Sayyar","year":"2019","journal-title":"Liver Int"},{"issue":"3","key":"pone.0290352.ref047","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jacl.2014.02.003","article-title":"Association between alcohol intake, overweight, and serum lipid levels and the risk analysis associated with the development of dyslipidemia","volume":"8","author":"Z. Shen","year":"2014","journal-title":"J Clin Lipidol"},{"issue":"8","key":"pone.0290352.ref048","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.metabol.2016.05.003","article-title":"Non-alcoholic fatty liver disease and dyslipidemia: An update","volume":"65","author":"N. Katsiki","year":"2016","journal-title":"Metabolism"},{"issue":"8","key":"pone.0290352.ref049","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.cgh.2018.04.023","article-title":"Treatment of Dyslipidemia in Common Liver Diseases","volume":"16","author":"E. K. Speliotes","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"17\u201318","key":"pone.0290352.ref050","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s00508-019-01544-5","article-title":"Patterns and prevalence of dyslipidemia in patients with different etiologies of chronic liver disease","volume":"131","author":"L. W. Unger","year":"2019","journal-title":"Wien Klin Wochenschr"},{"issue":"2","key":"pone.0290352.ref051","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.atherosclerosis.2006.11.036","article-title":"Primary biliary cirrhosis, hyperlipidemia, and atherosclerotic risk: a systematic review","volume":"194","author":"A. Sorokin","year":"2007","journal-title":"Atherosclerosis"},{"issue":"4","key":"pone.0290352.ref052","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.jhep.2020.10.004","article-title":"Systemic inflammation increases across distinct stages of advanced chronic liver disease and correlates with decompensation and mortality","volume":"74","author":"D. Costa","year":"2021","journal-title":"J Hepatol"},{"issue":"16","key":"pone.0290352.ref053","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.4254\/wjh.v7.i16.1974","article-title":"Role of systemic inflammation in cirrhosis: From pathogenesis to prognosis","volume":"7","author":"M. Dirchwolf","year":"2015","journal-title":"World J Hepatol"},{"issue":"6","key":"pone.0290352.ref054","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1002\/hep.28123","article-title":"Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009","volume":"62","author":"Z. M. Younossi","year":"2015","journal-title":"Hepatology"},{"issue":"4","key":"pone.0290352.ref055","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41575-020-00381-6","article-title":"Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention","volume":"18","author":"D. Q. Huang","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"8","key":"pone.0290352.ref056","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1002\/lt.24134","article-title":"Increased risk of portal vein thrombosis in patients with cirrhosis due to nonalcoholic steatohepatitis","volume":"21","author":"J. G. Stine","year":"2015","journal-title":"Liver Transpl"},{"issue":"3","key":"pone.0290352.ref057","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4254\/wjh.v9.i3.139","article-title":"Advanced non-alcoholic steatohepatitis cirrhosis: A high-risk population for pre-liver transplant portal vein thrombosis","volume":"9","author":"J. G. Stine","year":"2017","journal-title":"World J Hepatol"},{"issue":"10","key":"pone.0290352.ref058","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1056\/NEJM199903113401001","article-title":"Rising incidence of hepatocellular carcinoma in the United States","volume":"340","author":"H. B. 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