Evidence mapPaperPMID 33108366Full record

ArticlePloS one2020

Hospital admission with non-alcoholic fatty liver disease is associated with increased all-cause mortality independent of cardiovascular risk factors.

Jake P Mann, Paul Carter, Matthew J Armstrong, Hesham K Abdelaziz, Hardeep Uppal, Billal Patel, Suresh Chandran, Ranjit More, Philip N Newsome, Rahul Potluri

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Jake P MannMRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.ORCID 0000-0002-4711-9215
Paul CarterACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, United Kingdom.
Matthew J ArmstrongLiver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Hesham K AbdelazizLancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom.ORCID 0000-0002-5165-9919
Hardeep UppalACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, United Kingdom.
Billal PatelLancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom.
Suresh ChandranDepartment of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, United Kingdom.
Ranjit MoreLancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom.ORCID 0000-0002-9996-4226
Philip N NewsomeNational Institute for Health Research Liver Biomedical Research Unit at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, United Kingdom.
Rahul PotluriACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, United Kingdom.
Aston University · GBUniversity of Liverpool · GBUniversity Hospitals Birmingham NHS Foundation Trust · GBPennine Acute Hospitals NHS Trust · GB

Funding

Wellcome TrustWellcome Trust 216329/Z/19/Z
6 · The paper itself

Abstract

Non-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. It is not clear if the higher reported mortality rates in individuals with non-cirrhotic NAFLD are entirely accounted for by complications of atherosclerosis and diabetes. Therefore, we aimed to describe the CVD burden and mortality in NAFLD when adjusting for metabolic risk factors using a 'real world' cohort. We performed a retrospective study of patients followed-up after an admission to non-specialist hospitals with a NAFLD-spectrum diagnosis. Non-cirrhotic NAFLD and NAFLD-cirrhosis patients were defined by ICD-10 codes. Cases were age-/sex-matched with non-NAFLD hospitalised patients. All-cause mortality over 14-years follow-up after discharge was compared between groups using Cox proportional hazard models adjusted for demographics, CVD, and metabolic syndrome components. We identified 1,802 patients with NAFLD-diagnoses: 1,091 with non-cirrhotic NAFLD and 711 with NAFLD-cirrhosis, matched to 24,737 controls. There was an increasing burden of CVD with progression of NAFLD: for congestive heart failure 3.5% control, 4.2% non-cirrhotic NAFLD, 6.6% NAFLD-cirrhosis; and for atrial fibrillation 4.7% control, 5.9% non-cirrhotic NAFLD, 12.1% NAFLD-cirrhosis. Over 14-years follow-up, crude mortality rates were 14.7% control, 13.7% non-cirrhotic NAFLD, and 40.5% NAFLD-cirrhosis. However, after adjusting for demographics, non-cirrhotic NAFLD (HR 1.3 (95% CI 1.1-1.5)) as well as NAFLD-cirrhosis (HR 3.7 (95% CI 3.0-4.5)) patients had higher mortality compared to controls. These differences remained after adjusting for CVD and metabolic syndrome components: non-cirrhotic NAFLD (HR 1.2 (95% CI 1.0-1.4)) and NAFLD-cirrhosis (HR 3.4 (95% CI 2.8-4.2)). In conclusion, from a large non-specialist registry of hospitalised patients, those with non-cirrhotic NAFLD had increased overall mortality compared to controls even after adjusting for CVD.

Indexed as

HospitalizationCardiovascular DiseasesCase-Control StudiesFemaleHumansLiverMaleMiddle AgedNon-alcoholic Fatty Liver DiseaseOdds RatioRisk Factors

Identifiers

PMID33108366
PMCPMC7591046
OpenAlexW3097213660

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.