Inpatient Decompensated Chronic Liver Disease: Epidemiology and Hospital Outcomes in Tertiary Care

Authors

  • M Asim Hamza Gastroenterology, Hepatology and General Internal Medicine. Countess Of Chester Hospital, Health Education England, UK Author
  • Jamal Shah Royal Blackburn Hospital, City Author
  • Irfan Central Hospital Sharjah, UAE Author

Keywords:

decompensated chronic liver diseases, DCLD, epidemiology, disease outcome

Abstract

Introduction: decompensated chronic liver diseases (DCLD) is leading cause of global mortality and morbity with varied aetiological factors and inconsistent outcoms. Extensive literature is available about its clinical and management aspect except epidemiological outcomes therefore this study aims to characterize the epidemiology, and hospital outcomes of patients admitted with decompensated chronic liver disease in a tertiary care hospital.

Methodology: This analytical cross-sectional study was conducted at Khyber Teaching hospital & Hayat Medical Complex from March 2019 to April 2021 among adult inpatients with confirmed cirrhosis. After obtaining ethical approval and informed consent, data on demographic, and disease characteristic was recorded and analyzed using SPSS v26. The primary outcome i.e., discharge status, improved vs died, was testes by independednt t-tests and chi-square/Fisher’s exact test with p<0.05 value.

Results:

Total 61 diagnosed cases of DCLD, male 36(59%), with mean age of 49.61±14.028 years, mean duration of disease as 3.94±3.649 years and 4.02±1.576 days of LOS were included. The mortality of in-patient DCLD patients appeared 12(19.7%). Only aetiology was significantly associated with patient outcomes. Patients who imporved had longer hospital stay.

Conclusion:

Outcomes in DCLD are strongly influenced by non-clinical forces. Social class was more important in predicting death than clinical factors, while gender and disease duration mattered less than expected. The high death rate from hepatitis C needs immediate action to improve access to care. Also, staying longer in the hospital may help save lives by allowing better management of complications. 

Author Biographies

  • M Asim Hamza, Gastroenterology, Hepatology and General Internal Medicine. Countess Of Chester Hospital, Health Education England, UK

    MRCP Specialist Registrar 

  • Jamal Shah, Royal Blackburn Hospital, City

    Medical Registrar Internal medicine 
    MBBS FCPS MRCP UK, MRCP Ire 

  • Irfan, Central Hospital Sharjah, UAE

    MBBS, FCPS-ii

    Junior Registrar

References

Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of liver disease: 2023 update. J Hepatol. 2023 Aug;79(2):516-537. DOI: https://doi.org/10.1016/j.jhep.2023.03.017

Battle A, Mudd J, Ahlenstiel G, Kalo E. Liver Cirrhosis: Evolving Definitions, and Recent Advances in Diagnosis, Prevention and Management. Livers. 2025; 5(3):28. DOI: https://doi.org/10.3390/livers5030028

Gustot T, Stadlbauer V, Laleman W, Alessandria C, Thursz M. Transition to decompensation and acute-on-chronic liver failure: Role of predisposing factors and precipitating events.Journal of Hepatology. 2021.75;S36 - S48

Cheemerla S, Balakrishnan M. Global Epidemiology of Chronic Liver Disease. Clin Liver Dis (Hoboken). 2021 Jun 4;17(5):365-370. DOI: https://doi.org/10.1002/cld.1061

Mohammadi M, Hasjim BJ, Balbale SN, Polineni P, Huang AA, Paukner M, Banea T, Dentici O, Vitello DJ, Obayemi JE, Duarte-Rojo A, Nadig SN, VanWagner LB, Zhao L, Mehrotra S, Ladner DP. Disease trajectory and competing risks of patients with cirrhosis in the US. PLoS One. 2025 Feb 14;20(2):e0313152. DOI: https://doi.org/10.1371/journal.pone.0313152

Mallik M, Singhai A, Khadanga S, Ingle V. The Significant Morbidity and Mortality Indicators in Patients of Cirrhosis. Cureus. 2022 Jan 14;14(1):e21226. DOI: https://doi.org/10.7759/cureus.21226

Bhattarai S. Complications and Mortality in Hospitalised Patients With Decompensated Cirrhosis of Liver in a Tertiary Care Centre in Nepal. Cureus. 2020 Aug 24;12(8):e9996. DOI: https://doi.org/10.7759/cureus.9996

Fleming KM, Aithal GP, Card TR, West J. All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver Int. 2012 Jan;32(1):79-84. DOI: https://doi.org/10.1111/j.1478-3231.2011.02517.x

Ifrah A, Fromer R, Gayner AH, Yeung HM. Discharge Outcomes of Hospitalized Patients with New Onset Decompensated Cirrhosis. Dig Dis Sci. 2024 Sep;69(9):3220-3225. DOI: https://doi.org/10.1007/s10620-024-08574-8

Tapper EB, Parikh ND. Diagnosis and Management of Cirrhosis and Its Complications: A Review. JAMA. 2023;329(18):1589–1602. DOI: https://doi.org/10.1001/jama.2023.5997

Salim A, Farooq MO, Saleem S, Malik K. Financial burden and social implications of chronic liver disease in a patient population group in Pakistan. Pak J Med Sci. 2024 Aug;40(7):1503-1508. DOI: https://doi.org/10.12669/pjms.40.7.7976.

Golembiewski E, Allen KS, Blackmon AM, Hinrichs RJ, Vest JR. Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review. JMIR Public Health Surveill. 2019 Oct 7;5(4):e12846. DOI: https://doi.org/10.2196/12846.

Khosravizadeh O, Vatankhah S, Bastani P, Kalhor R, Alirezaei S, Doosty F. Factors affecting length of stay in teaching hospitals of a middle-income country. Electron Physician. 2016 Oct 25;8(10):3042-3047. DOI: https://doi.org/10.19082/3042

Askgaard G, Fleming KM, Crooks C, Kraglund F, Jensen CB, West J et al. AskSocioeconomic inequalities in the incidence of alcohol-related liver disease: A nationwide Danish study. The Lancet Regional Health – Europe. 2021. 8; 100172:1-9

Collis D. Social grade: A classification tool – July 2009 [Internet]. Ipsos MediaCT; 2009 [cited 2025 Jun 28]. Available from: https://www.ipsos.com/sites/default/files/publication/6800-03/MediaCT_thoughtpiece_Social_Grade_July09_V3_WEB.pdf

Mukerji AN, Patel V, Jain A. Improving survival in decompensated cirrhosis. Int J Hepatol. 2012;2012:318627. DOI: https://doi.org/10.1155/2012/318627.

Shah AS, Amarapurkar DN. Natural History of Cirrhosis of Liver after First Decompensation: A Prospective Study in India. J Clin Exp Hepatol. 2018 Mar;8(1):50-57. DOI: https://doi.org/10.1016/j.jceh.2017.06.001.

Khan HA, Din NU, Iqbal S, Abbas G, Yousaf M, Shah BM, Umam S. Mortality and length of hospital stay in patients with liver cirrhosis based on their meld score: retracted article. Journal of Medical Sciences. 20224; 32(1):12–17. DOI: https://doi.org/10.52764/jms.24.32.1.2

Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019 Jan;70(1):151-171. DOI: https://doi.org/10.1016/j.jhep.2018.09.014

Mazumder NR, Celaj S, Atiemo K, Daud A, Jackson KL, Kho A, Levitsky J, Ladner DP. Liver-related mortality is similar among men and women with cirrhosis. J Hepatol. 2020 Nov;73(5):1072-1081. DOI: https://doi.org/10.1016/j.jhep.2020.04.022.

Mellinger, Jessica L. High 10-year mortality in alcohol-related liver disease: where do we go from here? The Lancet Gastroenterology & Hepatology2023.8( 11): 961 – 962.

Volk ML, Tocco RS, Bazick J, Rakoski MO, Lok AS. Hospital readmissions among patients with decompensated cirrhosis. Am J Gastroenterol. 2012 Feb;107(2):247-52. DOI: https://doi.org/10.1038/ajg.2011.314.

Samonakis DN, Koulentaki M, Coucoutsi C, Augoustaki A, Baritaki C, Digenakis E, Papiamonis N, Fragaki M, Matrella E, Tzardi M, Kouroumalis EA. Clinical outcomes of compensated and decompensated cirrhosis: A long term study. World J Hepatol. 2014 Jul 27;6(7):504-12. DOI: https://doi.org/10.4254/wjh.v6.i7.504.

Verna EC, Morelli G, Terrault NA, Lok AS, Lim JK, Di Bisceglie AM, Zeuzem S, Landis CS, Kwo P, Hassan M, Manns MP, Vainorius M, Akushevich L, Nelson DR, Fried MW, Reddy KR. DAA therapy and long-term hepatic function in advanced/decompensated cirrhosis: Real-world experience from HCV-TARGET cohort. J Hepatol. 2020 Sep;73(3):540-548. DOI: https://doi.org/10.1016/j.jhep.2020.03.031.

Qazi Arisar FA, Kamran M, Nadeem R, Jafri W. Impact of Severity of Chronic Liver Disease on Health-Related Economics.Hepat Mon.2020;20(6):e97933. https://doi.org/10.5812/hepatmon.97933

Kardashian A, Serper M, Terrault N, Nephew LD. Health disparities in chronic liver disease. Hepatology. 2023 Apr 1;77(4):1382-1403. DOI: https://doi.org/10.1002/hep.32743.

Al-Smadi K, Qureshi A, Buitrago M, Ashouri B, Kayali Z. Survival and Disease Progression in Older Adult Patients With Cirrhosis: A Retrospective Study. Int J Hepatol. 2024 Aug 8;2024:5852680. DOI: https://doi.org/10.1155/2024/5852680.

Second issue

Published

01/01/2026

Issue

Vol. 1 No. 2 (2025): Online

Section

Original Articles

License

Copyright (c) 2026 M Asim Hamza, Jamal Shah, Irfan (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

All articles and/or materials are published under the CC BY-ND 4.0 International License, which permits sharing and redistribution in any medium or format, provided the work remains unchanged and is correctly attributed to the original authors and MedPulse Spectrum.

How to Cite

Inpatient Decompensated Chronic Liver Disease: Epidemiology and Hospital Outcomes in Tertiary Care. (2026). MedPulse Spectrum, 1(2). https://jouex.com/index.php/medpulspect/article/view/26