Evidence map›Paper›PMID 34039492›Full record

ReviewJournal of hepatology2021

Pathophysiology of decompensated cirrhosis: Portal hypertension, circulatory dysfunction, inflammation, metabolism and mitochondrial dysfunction.

Cornelius Engelmann, Joan Clària, Gyongyi Szabo, Jaume Bosch, Mauro Bernardi

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 206 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
206citing papers in PubMed, 7 pooled it
–field-weighted citation impact
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

206 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
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  8. Trial
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  16. Post-TIPS Dynamics of von Willebrand Factor for Risk Stratification After TIPS Placement.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  17. Observational
  18. Review
  19. Article
  20. Article

146 more citing papers are in PubMed but not listed here.

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

5 authors.

Cornelius EngelmannDepartment of Hepatology and Gastroenterology, Charité Universitätsmedizin Berlin, Berlin, Germany; Institute for Liver and Digestive Health, University College London, London, United Kingdom; Section Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany; Berlin Institute of Health (BIH), Berlin, Germany. Electronic address: cornelius.engelmann@charite.de.
Joan ClàriaEuropean Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain; Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS and CIBERehd, Spain; Department of Biomedical Sciences, University of Barcelona, Barcelona, Spain.
Gyongyi SzaboDepartment of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
Jaume BoschIDIBAPS and CIBERehd, University of Barcelona, Barcelona, Spain; Department for Biomedical Research (DBMR), Bern University, Bern, Switzerland.
Mauro BernardiDepartment of Medical and Surgical Sciences; Alma Mater Studiorum - University of Bologna; Italy.

Funding

Alcoholic Hepatitis Clinical and Translational Network Late Phase Clinical Trials and Observational Studies 4/9U01AA026977 · NIAAA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI SZABO, GYONGYI · 2018 to 2022
$1.8M
NIAAA NIH HHS U01 AA026977
6 · The paper itself

Abstract

Patients with acutely decompensated cirrhosis have a dismal prognosis and frequently progress to acute-on-chronic liver failure, which is characterised by hepatic and extrahepatic organ failure(s). The pathomechanisms involved in decompensation and disease progression are still not well understood, and as specific disease-modifying treatments do not exist, research to identify novel therapeutic targets is of the utmost importance. This review amalgamates the latest knowledge on disease mechanisms that lead to tissue injury and extrahepatic organ failure - such as systemic inflammation, mitochondrial dysfunction, oxidative stress and metabolic changes - and marries these with the classical paradigms of acute decompensation to form a single paradigm. With this detailed breakdown of pathomechanisms, we identify areas for future research. Novel disease-modifying strategies that break the vicious cycle are urgently required to improve patient outcomes.

Indexed as

Acute-On-Chronic Liver FailureLiver CirrhosisHumansInflammationLiver CirculationOxidative StressPrognosisACLFAcute-on-chronic liver failureAscitesCirrhosisDAMPHepatic encephalopathyOrgan failurePAMPTissue injuryVariceal bleeding

Identifiers

PMID34039492
PMCPMC9272511

What Socratic holds

Textmetadata
LicenceTDM
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.