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Updated: Sep 1, 2025
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Missed diagnosis of cirrhosis in the inpatient setting
Alpesh N Amin1, Peter H Nguyen1, Elliot B Tapper2
1Department of Medicine, University of California Irvine, Irvine, California, USA.
Insights
Cirrhosis is a major cause of death, often presenting with undiagnosed complications like hepatic encephalopathy, ascites, and varices. Early recognition is crucial to improve patient outcomes and reduce healthcare costs.
Area of Science:
- Hepatology
- Internal Medicine
- Public Health
Background:
- Cirrhosis represents a significant global and national mortality burden.
- It is a progressive liver disease with severe complications, including hepatic encephalopathy, ascites, and varices.
- Patients frequently present with these complications before a formal cirrhosis diagnosis.
Purpose of the Study:
- To highlight the epidemiology of liver disease and cirrhosis.
- To discuss the common complications of cirrhosis: hepatic encephalopathy, ascites, and varices.
- To analyze the impact of delayed or missed cirrhosis diagnoses on patient outcomes and healthcare utilization.
Main Methods:
- Literature review on cirrhosis epidemiology and complications.
- Analysis of healthcare burden associated with undiagnosed cirrhosis.
- Discussion of clinical recognition and management strategies.
Main Results:
- Cirrhosis leads to substantial mortality and healthcare costs.
- Undiagnosed cirrhosis patients often present with advanced complications.
- Delayed diagnosis impacts disease progression and patient management.
Conclusions:
- Timely diagnosis of cirrhosis and its complications is critical.
- Clinician awareness of presenting signs can improve patient management.
- Addressing diagnostic delays can mitigate adverse outcomes and reduce healthcare system strain.
Abstract:
Cirrhosis accounts for a large number of deaths in the United States and worldwide, leading to an increasing burden on the healthcare system. Cirrhosis is, however, a progressive disease with different potential complications related to liver dysfunction and portal hypertension. Often, patients may present with complications of cirrhosis without having been diagnosed previously. It is pertinent that clinicians recognize these signs to place patients on an appropriate course of management to help delay or avoid further disease progression while avoiding deleterious outcomes and unnecessary utilization. We will discuss the epidemiology of liver disease, cirrhosis, and its complications (hepatic encephalopathy, ascites, and varices). In this study, we will discuss the rationale and impact of missing these diagnoses on the healthcare system and patient.
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