Changing Etiological Patterns and Predictors of In-Hospital Mortality in Decompensated Cirrhosis: A 10-Year Cohort Study Before and After COVID-19.

Publication date: Jun 06, 2026

Decompensated cirrhosis is associated with high in-hospital mortality, influenced by disease severity and underlying etiology. The COVID-19 pandemic may have altered both the etiological spectrum and clinical presentation of hospitalized patients. This study aimed to assess longitudinal changes in etiology and identify predictors of in-hospital mortality over a 10-year period. We conducted a retrospective cohort study including 812 patients hospitalized with decompensated liver cirrhosis between 2015 and 2025. Patients were grouped into pre-COVID-19 (2015-2019), COVID-19 (2020-2021) and post-COVID-19 (2022-2025) periods. Etiological factors and mortality rates were compared using chi-square tests. Independent predictors were identified through multivariate analysis. A clinical risk score based on Child-Pugh stage, platelet count and age was developed and evaluated using ROC analysis. Alcohol-related cirrhosis increased significantly from 51. 2% (pre-COVID-19) to 90. 4% (COVID-19) and remained high post-COVID-19 (86. 3%) (p

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Concepts Keywords
Alcohol alcohol-related cirrhosis
Liver COVID-19
Platelet decompensated cirrhosis
Thrombocytopenia liver cirrhosis
thrombocytopenia

Semantics

Type Source Name
disease MESH Cirrhosis
disease MESH COVID-19
disease MESH liver cirrhosis
drug DRUGBANK Saquinavir
drug DRUGBANK Ethanol
disease MESH included
disease MESH thrombocytopenia
disease MESH Emergency
drug DRUGBANK Coenzyme M
disease MESH drd
disease MESH cytopenia
disease MESH alcoholic fatty liver
disease MESH NAFLD
disease MESH Portal hypertension
disease MESH bleeding
disease MESH hepatic encephalopathy
disease MESH peritonitis
disease MESH hepatorenal syndrome
disease MESH hepatocellular carcinoma
pathway KEGG Hepatocellular carcinoma
drug DRUGBANK Trestolone
disease MESH hepatitis
disease MESH infection
disease MESH liver disease
drug DRUGBANK Human Serum Albumin
disease MESH ascites
disease MESH death

Original Article

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