Etiological Spectrum of Cirrhosis in India: A Systematic Review and Meta-analysis

Moon, 2020, Contemporary epidemiology of chronic liver disease and cirrhosis, Clin Gastroenterol Hepatol, 18, 2650, 10.1016/j.cgh.2019.07.060 Mondal, 2022, Epidemiology of liver diseases in India, Clin Liver Dis, 19, 114, 10.1002/cld.1177 Liu, 2022, Epidemiology of liver cirrhosis and associated complications: current knowledge and future directions, World J Gastroenterol, 28, 5910, 10.3748/wjg.v28.i41.5910 Devarbhavi, 2023, Global burden of liver disease: 2023 update, J Hepatol, S0168 Asrani, 2019, Burden of liver diseases in the world, J Hepatol, 70, 151, 10.1016/j.jhep.2018.09.014 Mukherjee, 2017, Etiology and mode of presentation of chronic liver diseases in India: a multi centric study, PLoS One, 12, 10.1371/journal.pone.0187033 Schuppan, 2008, Liver cirrhosis, Lancet, 371, 838, 10.1016/S0140-6736(08)60383-9 Asrani, 2013, Natural history of cirrhosis, Curr Gastroenterol Rep, 15, 308, 10.1007/s11894-012-0308-y All India Professionals' Congress-Official Site of All India Professionals' Congress [Internet]. Available from: https://www.profcongress.com/chapters/. Hoy, 2012, Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement, J Clin Epidemiol, 65, 934, 10.1016/j.jclinepi.2011.11.014 Acharya, 2002, Vaccination for hepatitis A virus is not required for patients with chronic liver disease in India, Natl Med J India, 15, 267 Acharya, 2003, Seroepidemiology of hepatitis A virus infection among school children in Delhi and north Indian patients with chronic liver disease: implications for HAV vaccination, J Gastroenterol Hepatol, 18, 822, 10.1046/j.1440-1746.2003.03051.x Acharya, 1993, A prospective randomized study to evaluate propranolol in patients undergoing long-term endoscopic sclerotherapy, J Hepatol, 19, 291, 10.1016/S0168-8278(05)80585-9 Anand, 2004, Should one vaccinate patients with chronic liver disease for hepatitis A virus in India?, J Assoc Phys India, 52, 785 Anand, 2022, European working group on sarcopenia in older people (EWGSOP2) criteria with population-based skeletal muscle index best predicts mortality in asians with cirrhosis, J Clin Exp Hepatol, 12, 52, 10.1016/j.jceh.2021.03.015 Arora, 2020, Profile of acute kidney injury in patients with decompensated cirrhosis at a tertiary-care center in uttarakhand, India, Dig Dis, 38, 335, 10.1159/000504836 Arora, 1998, Portai hypertension in North Indian children, Indian J Pediatr, 65, 585, 10.1007/BF02730901 Bajpai, 2019, Spectrum of respiratory viral infection liver disease patients with cirrhosis admitted in critical care unit, J Lab Physicians, 11, 356 Chawla, 2011, Predicting mortality across a broad spectrum of liver disease—an assessment of model for end-stage liver disease (MELD), child–turcotte–pugh (CTP), and creatinine-modified CTP scores, J Clin Exp Hepatol, 1, 161, 10.1016/S0973-6883(11)60233-8 Chawla, 1998, Portal hemodynamics by duplex Doppler sonography in different grades of cirrhosis, Dig Dis Sci, 43, 354, 10.1023/A:1018814624307 Chawlani, 2015, Adrenal insufficiency predicts early mortality in patients with cirrhosis, United Eur Gastroenterol J, 3, 529, 10.1177/2050640614552314 Dangwal, 1997, Clinical spectrum of chronic liver disease in north Indian children, Trop Gastroenterol, 18, 174 Dasarathy, 1992, A prospective randomized trial comparing repeated endoscopic sclerotherapy and propranolol in decompensated (child class B and C) cirrhotic patients, Hepatology, 16, 89, 10.1002/hep.1840160116 Daschakraborty, 2012, Non-organ-specific autoantibodies in Indian patients with chronic liver disease, Indian J Gastroenterol, 31, 237, 10.1007/s12664-012-0247-4 De, 2021, Multiple cycles of granulocyte colony-stimulating factor increase survival times of patients with decompensated cirrhosis in a randomized trial, Clin Gastroenterol Hepatol, 19, 375, 10.1016/j.cgh.2020.02.022 Dhillon, 2007, Frequency of primary iron overload and HFE gene mutations (C282Y, H63D and S65C) in chronic liver disease patients in north India, World J Gastroenterol, 13, 2956, 10.3748/wjg.v13.i21.2956 Goel, 2016, Prevalence, severity, and impact on quality of life of restless leg syndrome in patients with liver cirrhosis in India, Indian J Gastroenterol, 35, 216, 10.1007/s12664-016-0668-6 Kaur, 2018, Etiological profile of cirrhosis in a tertiary care Institute in northern India, J Gastrointest Infect, 8, 28, 10.5005/jp-journals-10068-0017 Grover, 2022, Comparison of anthropometry, bioelectrical impedance, and dual-energy X-ray absorptiometry for body composition in cirrhosis, J Clin Exp Hepatol, 12, 467, 10.1016/j.jceh.2021.05.012 Grover, 2021, Effect of vitamin D supplementation on vitamin D level and bone mineral density in patients with cirrhosis: a randomized clinical trial, Am J Gastroenterol, 116, 2098, 10.14309/ajg.0000000000001272 Gulzar, 2009, Correlation of hepatic venous pressure gradient with variceal bleeding, size of esophageal varices, etiology, ascites and degree of liver dysfunction in cirrhosis of liver, Indian J Gastroenterol, 28, 59, 10.1007/s12664-009-0019-y Gupta, 2022, Prevalence of glucose metabolism disorder in liver cirrhosis and its correlation with risk factors of diabetes mellitus: a hospital-based cross sectional observational study from New Delhi, J Assoc Phys India, 70, 11 Gupta, 2001, Prevalence of hepatopulmonary syndrome in cirrhosis and extrahepatic portal venous obstruction, Am J Gastroenterol, 96, 3395, 10.1111/j.1572-0241.2001.05274.x Gupta, 2010, Role of small intestinal bacterial overgrowth and delayed gastrointestinal transit time in cirrhotic patients with minimal hepatic encephalopathy, J Hepatol, 53, 849, 10.1016/j.jhep.2010.05.017 Halkurike-Jayadevappa, 2019, Liver disease severity is poorly related to the presence of restless leg syndrome in patients with cirrhosis, Neurol India, 67, 732 Jain, 2011, Lack of association of primary iron overload and common HFE gene mutations with liver cirrhosis in adult Indian population, Indian J Gastroenterol, 30, 161, 10.1007/s12664-011-0109-5 Jain, 2021, Alcohol associated liver cirrhotics have higher mortality after index hospitalization: long-term data of 5,138 patients, Clin Mol Hepatol, 27, 175, 10.3350/cmh.2020.0068 Jain, 2012, Serum endotoxin and inflammatory mediators in patients with cirrhosis and hepatic encephalopathy, Dig Liver Dis, 44, 1027, 10.1016/j.dld.2012.07.002 Jindal, 2015, Bispectral index monitoring for diagnosis and assessment of severity of hepatic encephalopathy in cirrhotic patients, Dig Liver Dis, 47, 769, 10.1016/j.dld.2015.04.014 Kakkar, 2021, Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India, Hematol Transfus Cell Ther, 43, 280, 10.1016/j.htct.2020.05.010 Kapoor, 2020, Prevalence of cirrhotic cardiomyopathy and its relationship with serum pro-brain natriuretic peptide, hepatorenal syndrome, spontaneous bacterial peritonitis, and mortality, Indian J Gastroenterol, 39, 481, 10.1007/s12664-020-01083-2 Karoli, 2016, Study of hepatic osteodystrophy in patients with chronic liver disease, J Clin Diagn Res, 10, OC31 Kharbanda, 2003, Peripheral neuropathy in liver cirrhosis, J Gastroenterol Hepatol, 18, 922, 10.1046/j.1440-1746.2003.03023.x Kumar, 2017, Vitamin D status in patients with cirrhosis of the liver and their relatives—a case control study from North India, Indian J Gastroenterol, 36, 50, 10.1007/s12664-017-0727-7 Kumar, 2020, Evaluation of non-invasive marker of esophageal varices in cirrhosis of liver, J Fam Med Prim Care, 9, 992, 10.4103/jfmpc.jfmpc_854_19 Kumar, 2020, Serum 25-hydroxyvitamin D level in patients with chronic liver disease and its correlation with hepatic encephalopathy: a cross-sectional study, J Fam Med Prim Care, 9, 798, 10.4103/jfmpc.jfmpc_1084_19 Kumar, 2008, Histological subclassification of cirrhosis based on histological-haemodynamic correlation: histological subclassification of cirrhosis and hepatic venous pressure, Aliment Pharmacol Ther, 27, 771, 10.1111/j.1365-2036.2008.03653.x Kumar, 2022, Does treatment of erectile dysfunction with pde 5 inhibitor tadalafil improve quality of life in male patients with compensated chronic liver disease? A prospective pilot study, J Clin Exp Hepatol, 12, 1083, 10.1016/j.jceh.2022.01.009 Kumar, 2010, Clinical, laboratory, and hemodynamic parameters in portal hypertensive gastropathy: a study of 254 cirrhotics, J Clin Gastroenterol, 44, 294, 10.1097/MCG.0b013e3181b37ea1 Kumar, 2017, Correlation of transient elastography with hepatic venous pressure gradient in patients with cirrhotic portal hypertension: a study of 326 patients from India, World J Gastroenterol, 23, 687, 10.3748/wjg.v23.i4.687 Kundal, 2017, Chronic liver disease, Etiological Spectrum in Adults, 19, 145 Lal, 2018, Weekly regimen of vitamin D supplementation is more efficacious than stoss regimen for treatment of vitamin D deficiency in children with chronic liver diseases, Eur J Pediatr, 177, 827, 10.1007/s00431-018-3123-0 Lunia, 2013, Small intestinal bacterial overgrowth and delayed orocecal transit time in patients with cirrhosis and low-grade hepatic encephalopathy, Hepatol Int, 7, 268, 10.1007/s12072-012-9360-9 Lunia, 2014, Probiotics prevent hepatic encephalopathy in patients with cirrhosis: a randomized controlled trial, Clin Gastroenterol Hepatol, 12, 1003, 10.1016/j.cgh.2013.11.006 Maharshi, 2016, Efficacy of nutritional therapy for patients with cirrhosis and minimal hepatic encephalopathy in a randomized trial, Clin Gastroenterol Hepatol, 14, 454, 10.1016/j.cgh.2015.09.028 Makol, 2018, Association of liver cirrhosis severity with type 2 diabetes mellitus in hepatocellular carcinoma, Exp Biol Med, 243, 323, 10.1177/1535370217744511 Misra, 2005, Colonic changes in patients with cirrhosis and in patients with extrahepatic portal vein obstruction, Endoscopy, 37, 454, 10.1055/s-2005-861252 Nayak, 2012, Etiologic types of end-stage chronic liver disease in adults: analysis of prevalence and their temporal changes from a study on native liver explants, Eur J Gastroenterol Hepatol, 24, 1199, 10.1097/MEG.0b013e32835643f1 Padia, 2021, Cystatin C and interleukin-6 for prognosticating patients with acute decompensation of cirrhosis, JGH Open, 5, 459, 10.1002/jgh3.12516 Paul, 2015, To study the incidence, predictive factors and clinical outcome of spontaneous bacterial peritonitis in patients of cirrhosis with ascites, J Clin Diagn Res, 9, OC09 Poddar, 2008, Etiological spectrum of esophageal varices due to portal hypertension in Indian children: is it different from the West?, J Gastroenterol Hepatol, 23, 1354, 10.1111/j.1440-1746.2007.05102.x Prakash, 2011, Clinical spectrum of renal disorders in patients with cirrhosis of liver, Ren Fail, 33, 40, 10.3109/0886022X.2010.541582 Prasad, 2007, Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy, Hepatology, 45, 549, 10.1002/hep.21533 Premkumar, 2021, Clinical validation of global coagulation tests to guide blood component transfusions in cirrhosis and ACLF, J Clin Transl Hepatol, 9, 210 Rai, 2017, Haemostatic profile of patients with chronic liver disease- its correlation with severity and outcome, J Clin Diagn Res, 11, EC24 Rajeshwari, 2008, The clinical spectrum of chronic liver disease in children presenting to a tertiary level teaching hospital in New Delhi, Trop Doct, 38, 101, 10.1258/td.2007.060019 Rout, 2019, Development and validation of a novel model for outcomes in patients with cirrhosis and acute variceal bleeding, Dig Dis Sci, 64, 2327, 10.1007/s10620-019-05557-y Sarin, 1992, Factors influencing development of portal hypertensive gastropathy in patients with portal hypertension, Gastroenterology, 102, 994, 10.1016/0016-5085(92)90188-5 Sarin, 1988, Young v adult cirrhotics: a prospective, comparative analysis of the clinical profile, natural course and survival, Gut, 29, 101, 10.1136/gut.29.1.101 Sharma, 2017, Handgrip strength as an important bed side tool to assess malnutrition in patient with liver disease, J Clin Exp Hepatol, 7, 16, 10.1016/j.jceh.2016.10.005 Sharma, 2016, A study on the etiology of cirrhosis of liver in adults living in the Hills of Himachal Pradesh, India, Trop Gastroenterol, 37, 37, 10.7869/tg.317 Sharma, 2021, Nutritional assessment and factors affecting dietary intake in patients with cirrhosis: a single-center observational study, Nutrition, 84, 10.1016/j.nut.2020.111099 Sharma, 2012, Minimal hepatic encephalopathy in patients with cirrhosis by measuring liver stiffness and hepatic venous pressure gradient, Saudi J Gastroenterol, 18, 316, 10.4103/1319-3767.101126 Sharma, 2007, Prediction of large esophageal varices in patients with cirrhosis of the liver using clinical, laboratory and imaging parameters, J Gastroenterol Hepatol, 22, 1909, 10.1111/j.1440-1746.2006.04501.x Sharma, 2010, The haemodynamic response to propranolol in cirrhosis with arterial hypertension: a comparative analysis with normotensive cirrhotic patients: propranolol in cirrhosis with hypertension, Aliment Pharmacol Ther, 32, 105, 10.1111/j.1365-2036.2010.04308.x Sharma, 2012, Primary prophylaxis of overt hepatic encephalopathy in patients with cirrhosis: an open labeled randomized controlled trial of lactulose versus no lactulose: prophylaxis of hepatic encephalopathy, J Gastroenterol Hepatol, 27, 1329, 10.1111/j.1440-1746.2012.07186.x Shrestha, 2020, Factors affecting psychological burden on the informal caregiver of patients with cirrhosis: looking beyond the patient, J Clin Exp Hepatol, 10, 9, 10.1016/j.jceh.2019.06.002 Sidhu, 2018, L-ornithine L-aspartate in bouts of overt hepatic encephalopathy, Hepatology, 67, 700, 10.1002/hep.29410 Sidhu, 2021, Muscle strength and physical performance, rather than muscle mass, correlate with mortality in end-stage liver disease, Eur J Gastroenterol Hepatol, 33, 555, 10.1097/MEG.0000000000001761 Singh, 2006, Terlipressin versus albumin in paracentesis-induced circulatory dysfunction in cirrhosis: a randomized study, J Gastroenterol Hepatol, 21, 303, 10.1111/j.1440-1746.2006.04182.x Singh, 2022, Propranolol vs. band ligation for primary prophylaxis of variceal hemorrhage in cirrhotic patients with ascites: a randomized controlled trial, Hepatol Int, 16, 944, 10.1007/s12072-022-10361-4 Singh, 2013, Midodrine and clonidine in patients with cirrhosis and refractory or recurrent ascites: a randomized pilot study, Am J Gastroenterol, 108, 560, 10.1038/ajg.2013.9 Singh, 2012, Midodrine in patients with cirrhosis and refractory or recurrent ascites: a randomized pilot study, J Hepatol, 56, 348, 10.1016/j.jhep.2011.04.027 Singh, 2008, Midodrine versus albumin in the prevention of paracentesis-induced circulatory dysfunction in cirrhotics: a randomized pilot study, Am J Gastroenterol, 103, 1399, 10.1111/j.1572-0241.2008.01787.x Singh, 2018, Relative adrenal insufficiency in cirrhotic patients with ascites (hepatoadrenal syndrome), Dig Liver Dis, 50, 1232, 10.1016/j.dld.2018.05.011 Snehavardhan, 2020, Efficacy and safety of sodium benzoate in the management of hyperammonemia in decompensated chronic liver disease of the childhood—a double-blind randomized controlled trial, J Pediatr Gastroenterol Nutr, 70, 165, 10.1097/MPG.0000000000002521 Sood, 2014, Skin and soft tissue infections in cirrhotics: a prospective analysis of clinical presentation and factors affecting outcome, Indian J Gastroenterol, 33, 281, 10.1007/s12664-014-0454-2 Sood, 2017, Prevalence and clinical significance of IgA anti-tissue transglutaminase antibodies in patients with chronic liver disease: IgA anti-tTG in cirrhosis, J Gastroenterol Hepatol, 32, 446, 10.1111/jgh.13474 Srivastava, 2017, Prevalence, clinical profile, and outcome of ascitic fluid infection in children with liver disease, J Pediatr Gastroenterol Nutr, 64, 194, 10.1097/MPG.0000000000001348 Taneja, 2012, Inhibitory control test for the detection of minimal hepatic encephalopathy in patients with cirrhosis of liver, J Clin Exp Hepatol, 2, 306, 10.1016/j.jceh.2012.07.001 Thakur, 2019, Tadalafil, a phosphodiesterase-5 inhibitor, improves erectile dysfunction in patients with liver cirrhosis, J Clin Exp Hepatol, 9, 312, 10.1016/j.jceh.2018.07.007 Tyagi, 2011, Prevention of hepatorenal syndrome in patients with cirrhosis and ascites: a pilot randomized control trial between pentoxifylline and placebo, Eur J Gastroenterol Hepatol, 23, 210, 10.1097/MEG.0b013e3283435d76 Varakanahalli, 2018, Secondary prophylaxis of hepatic encephalopathy in cirrhosis of liver: a double-blind randomized controlled trial of l-ornithine l-aspartate versus placebo, Eur J Gastroenterol Hepatol, 30, 951, 10.1097/MEG.0000000000001137 Verma, 2017, Thyroid profile in patients of cirrhosis of liver: a cross-sectional study, J Clin Diagn Res, 11, OC06 Verma, 2014, Correlation of aspartate aminotransferase/platelet ratio index with hepatic venous pressure gradient in cirrhosis, United Eur Gastroenterol J, 2, 226, 10.1177/2050640614527084 Yachha, 1997, Current spectrum of hepatobiliary disorders in northern India, Indian Pediatr, 34, 885 Baijal, 2014, A multicenter prospective study of infections related morbidity and mortality in cirrhosis of liver, Indian J Gastroenterol, 33, 336, 10.1007/s12664-014-0461-3 Choudhuri, 2018, Etiological patterns, liver fibrosis stages and prescribing patterns of hepato-protective agents in Indian patients with chronic liver disease, J Assoc Phys India, 66, 58 Goswami, 2021, Primary prophylaxis patterns for hepatic encephalopathy in patients with liver cirrhosis: what are the current prescribing trends in specialty practice?, J Assoc Phys India, 69, 11 Rathi, 2019, Prevalence of minimal hepatic encephalopathy in patients with liver cirrhosis: a cross-sectional, clinicoepidemiological, multicenter, nationwide study in India: the predict study, J Clin Exp Hepatol, 9, 476, 10.1016/j.jceh.2018.09.009 Anoop, 2022, Eosinophil count: a predictor of in-hospital mortality in a cohort of cirrhosis patients with sepsis, Egypt Liver J, 12, 31, 10.1186/s43066-021-00167-8 Augustine, 2022, A study of upper gastrointestinal bleeding in chronic liver disease, Int J Acad Med Pharm, 4, 238 Baijal, 2010, Prevalence of tuberculosis in patients with cirrhosis of liver in western India, Trop Doct, 40, 163, 10.1258/td.2010.090463 Balakrishnan, 2017, Correlation of serum prolactin level to child pugh scoring system in cirrhosis of liver, J Clin Diagn Res, 11, OC30 Bale, 2018, Prevalence of and factors associated with minimal hepatic encephalopathy in patients with cirrhosis of liver, J Clin Exp Hepatol, 8, 156, 10.1016/j.jceh.2017.06.005 Bawankule, 2019, Clinical profile of patients with hepatic encephalopathy in cirrhosis of liver, J Datta Meghe Inst Med Sci Univ, 14, 130, 10.4103/jdmimsu.jdmimsu_88_18 Bhattacharya, 2019, Infection in cirrhosis: a prospective study, Ann Hepatol, 18, 862, 10.1016/j.aohep.2019.07.010 Bhattacharyya, 2016, Survey of alcohol-related cirrhosis at a tertiary care center in North East India, Indian J Gastroenterol, 35, 167, 10.1007/s12664-016-0651-2 Damodaran, 2022, A study of thyroid function tests as a prognostic marker in patients with cirrhosis, Int J Pharm Clin Res, 14, 391 Das, 2015, Study on assessment of renal function in chronic liver disease, J Clin Diagn Res, 9, OC09 Das, 2002, Discriminatory value of blood urea : creatinine ratio in upper gastrointestinal bleeding with and without cirrhosis of liver, 50, 243 De, 2000, Clinical and haemodynamic aspects of hepatopulmonary syndrome in Indian patients with cirrhosis, J Gastroenterol Hepatol, 15, 412, 10.1046/j.1440-1746.2000.02156.x Dhole, 2015, Chronic liver diseases in children: clinical profile and histology, J Clin Diagn Res, 9, SC04 Goel, 2013, A study of aetiology of portal hypertension in adults (including the elderly) at a tertiary centre in southern India, Indian J Med Res, 137, 922 Gupta, 2015, Prospective comparative study of inhibitory control test and psychometric hepatic encephalopathy score for diagnosis and prognosis of minimal hepatic encephalopathy in cirrhotic patients in the Indian subcontinent: comparison of ICT and PHES for MHE, J Dig Dis, 16, 400 Gurung, 2017, Pilot study of hepatitis b, c and human immunodeficiency viruses infections among patients with chronic liver diseases from north-east India attending a new tertiary care health set up at shillong, Indian J Med Sci, 69, 18, 10.18203/issn.0019-5359.IndianJMedSci20170485 Hamza, 2014, Risk factors of cellulitis in cirrhosis and antibiotic prophylaxis in preventing recurrence, Ann Gastroenterol, 27, 374 Jain, 2014, Magnitude of peripheral neuropathy in cirrhosis of liver patients from central rural India, Ann Indian Acad Neurol, 17, 409, 10.4103/0972-2327.144012 Jain, 2020, Explant liver evaluation decodes the mystery of cryptogenic cirrhosis, JGH Open, 4, 39, 10.1002/jgh3.12200 Jain, 2017, An insight into antibiotic resistance to bacterial infection in chronic liver disease, J Clin Exp Hepatol, 7, 305, 10.1016/j.jceh.2017.05.003 K, 2018, Health-related quality of life in liver cirrhosis patients using SF-36 and CLDQ questionnaires, Clin Exp Hepatol, 4, 232, 10.5114/ceh.2018.80124 Joseph, 2011, Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients, Saudi J Gastroenterol, 17, 36, 10.4103/1319-3767.74465 Juneja, 2009, Outcome of patients with liver cirrhosis admitted to a specialty liver intensive care unit in India, J Crit Care, 24, 387, 10.1016/j.jcrc.2008.12.013 Kadam, 2016, Ascitic fluid high sensitive C-reactive protein (hs-CRP). A prognostic marker in cirrhosis with spontaneous bacterial peritonitis, J Clin Diagn Res, 10, OC20 Khatua, 2019, Validation of International Club of Ascites subclassification of stage 1 acute kidney injury in chronic liver disease, JGH Open, 3, 290, 10.1002/jgh3.12152 Khatua, 2021, Acute kidney injury in hospitalized cirrhotic patients: risk factors, type of kidney injury, and survival, JGH Open, 5, 199, 10.1002/jgh3.12467 Khiangte, 2020, Prevalence and determinants of hepatopulmonary syndrome in decompensated chronic liver disease, Indian J Gastroenterol, 39, 362, 10.1007/s12664-020-01052-9 Kumar, 2020, Short-term mortality in patients with cirrhosis of the liver and acute kidney injury: a prospective observational study, Indian J Gastroenterol, 39, 457, 10.1007/s12664-020-01086-z Manohar, 2019, Predictors of three-month hospital readmissions and mortality in patients with cirrhosis of liver, Euroasian J Hepato-Gastroenterol, 9, 71, 10.5005/jp-journals-10018-1302 Lokesh, 2017, Advanced hepatocellular carcinoma: a regional cancer center experience of 48 cases, Indian J Cancer, 54, 526, 10.4103/ijc.IJC_373_17 Maidur, 2021, Prospective evaluation of factors affecting the outcome in cirrhotic patients requiring intensive care, Int J Curr Res Rev, 13, 63, 10.31782/IJCRR.2021.13120 Maitra, 2019, Spectrum of complications of chronic liver disease in gauhati medical college and hospital: a hospital based study, J Clin Diagn Res, 13, OC07 Mallik, 2022, The significant morbidity and mortality indicators in patients of cirrhosis, Cureus, 14 Mishra, 2020, A study on the temporal trends in the etiology of cirrhosis of liver in coastal eastern odisha, Euroasian J Hepato-Gastroenterol, 10, 1, 10.5005/jp-journals-10018-1312 Mishra, 2007, Applicability of MELD as a short-term prognostic indicator in patients with chronic liver disease: an Indian experience, J Gastroenterol Hepatol, 22, 1232, 10.1111/j.1440-1746.2007.04903.x Misra, 2021, Mortality pattern in cirrhosis: a reflection of liver disease burden in India, GastroHep, 3, 409, 10.1002/ygh2.497 Pazhanivel, 2011, Prevalence and risk factors for bacterial skin infection and mortality in cirrhosis, Ann Hepatol, 10, 15, 10.1016/S1665-2681(19)31581-9 Mugada, 2020, Patient counseling for chronic liver disease patients with anxiety and depression: a cross-sectional study, J Appl Pharmaceut Sci, 10, 63 Nandish, 2019, Adrenal insufficiency in decompensated cirrhotic patients without infection: prevalence, predictors and impact on mortality, J R Coll Physicians Edinb, 49, 277, 10.4997/jrcpe.2019.405 Nangliya, 2015, Study of trace elements in liver cirrhosis patients and their role in prognosis of disease, Biol Trace Elem Res, 165, 35, 10.1007/s12011-015-0237-3 Narayanasamy, 2018, High prevalent hypovitaminosis D is associated with dysregulation of calcium-parathyroid hormone-vitamin D Axis in patients with chronic liver diseases, J Clin Transl Hepatol, 7, 1, 10.14218/JCTH.2018.00018 Panagaria, 2010, Nutritional status and quality of life at varying degrees of clinical severity of chronic liver disease, Nutr Food Sci, 40, 581, 10.1108/00346651011090383 Patel, 2019, Predictors of 1-month and 3-months hospital readmissions in decompensated cirrhosis: a prospective study in a large asian cohort, Ann Hepatol, 18, 30, 10.5604/01.3001.0012.7859 Paul, 2013, Study of serum uric acid in chronic liver disease and its relation with other parameters, Int Res J Pharm, 4, 162, 10.7897/2230-8407.04736 Philips, 2019, A single-center experience on outcomes of complementary and alternative medicine use among patients with cirrhosis, Hepatol Commun, 3, 1001, 10.1002/hep4.1355 Punekar, 2018, A study of thyroid dysfunction in cirrhosis of liver and correlation with severity of liver disease, Indian J Endocrinol Metab, 22, 645, 10.4103/ijem.IJEM_25_18 Rajender, 2019, Restless leg syndrome a common undiagnosed comorbidity of clinical significance in cirrhosis, Gastroenterol Hepatol Bed Bench, 12, 13 Rajaragupathy, 2021, Comparison of albumin-bilirubin grade with child-pugh and model for end stage liver disease scores in chronic liver disease, Biochim Clin, 45, 141 Ray, 2000, Aetiological spectrum of chronic liver disease in eastern India, Trop Gastroenterol Off J Dig Dis Found, 21, 60 Ray, 2014, Trends of chronic liver disease in a tertiary care referral hospital in Eastern India, Indian J Publ Health, 58, 186, 10.4103/0019-557X.138630 Roni, 2013, Safety and efficacy of hepatitis B vaccination in cirrhosis of liver, Adv Virol, 2013, 1, 10.1155/2013/196704 Samanta, 2020, Validation of revised baveno VI criteria for screening of varices needing treatment in children with cirrhosis, Clin Exp Gastroenterol, 13, 503, 10.2147/CEG.S276182 Sanglodkar, 2019, Clinical audit to determine efficacy of daily infusion of low dose of 20% albumin in combination with antibiotics in patients with spontaneous bacterial peritonitis, Clin Exp Hepatol, 5, 301, 10.5114/ceh.2019.88774 Sarangapani, 2010, Noninvasive prediction of large esophageal varices in chronic liver disease patients, Saudi J Gastroenterol, 16, 38, 10.4103/1319-3767.58767 Sasidharan, 2012, Nutritional status and prognosis in cirrhotic patients, Trop Gastroenterol Off J Dig Dis Found, 33, 257 Shah, 2015, Coagulopathy in cirrhosis: a prospective study to correlate conventional tests of coagulation and bleeding following invasive procedures in cirrhotics, Indian J Gastroenterol, 34, 359, 10.1007/s12664-015-0584-1 Shah, 2018, Natural history of cirrhosis of liver after first decompensation: a prospective study in India, J Clin Exp Hepatol, 8, 50, 10.1016/j.jceh.2017.06.001 Shanavas, 2021, Association of sarcopenia with health related quality of life in cirrhotics, J Assoc Phys India, 69, 11 Simon, 2009, Aetiology of paediatric portal hypertension – experience of a tertiary care centre in South India, Trop Doct, 39, 42, 10.1258/td.2008.080050 Sindhu, 2020, Point shear wave elastography of the spleen in predicting the presence of esophageal varices in cirrhosis: liver stiffness vs. Spleen stiffness, J Diagn Med Sonogr, 36, 95, 10.1177/8756479319882006 Singh, 2020, Association of liver cirrhosis severity with anemia: does it matter?, Ann Gastroenterol, 33, 272 Somani, 2017, Thromboelastography for assessing the risk of bleeding in patients with cirrhosis—moving closer, J Clin Exp Hepatol, 7, 284, 10.1016/j.jceh.2017.03.001 Sudulagunta, 2015, Clinical profile and complications of paracentesis in refractory ascites patients with cirrhosis, Gastroenterol Res, 8, 228, 10.14740/gr661w Tanwar, 2020, Celiac disease and portal hypertension: a causal association or just a coincidence?, J Clin Exp Hepatol, 10, 290, 10.1016/j.jceh.2019.11.005 Singh Tejavath, 2021, Front Nutr, 8, 10.3389/fnut.2021.715795 Varghese, 2008, Predictors of variceal bleed among patients with liver cirrhosis in the era of sclerotherapy, Singap Med J, 49, 239 Vasepalli, 2022, Hepatogenous diabetes - a report from Central India, J Clin Exp Hepatol, 12, 312, 10.1016/j.jceh.2021.08.018 Barker, 2021, Conducting proportional meta-analysis in different types of systematic reviews: a guide for synthesisers of evidence, BMC Med Res Methodol, 21, 189, 10.1186/s12874-021-01381-z Sepanlou, 2020, The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017, Lancet Gastroenterol Hepatol, 5, 245, 10.1016/S2468-1253(19)30349-8 Shalimar, 2022, Prevalence of non-alcoholic fatty liver disease in India: a systematic review and meta-analysis, J Clin Exp Hepatol, 12, 818, 10.1016/j.jceh.2021.11.010 Pradeepa, 2021, Epidemiology of type 2 diabetes in India, Indian J Ophthalmol, 69, 2932, 10.4103/ijo.IJO_1627_21 Krishnamoorthy, 2020, Prevalence of metabolic syndrome among adult population in India: a systematic review and meta-analysis, PLoS One, 15, 10.1371/journal.pone.0240971 Ahirwar, 2019, Prevalence of obesity in India: a systematic review, Diabetes Metabol Syndr, 13, 318, 10.1016/j.dsx.2018.08.032 Wu, 2023, Trends in the incidence of cirrhosis in global from 1990 to 2019: a join point and age-period-cohort analysis, J Med Virol, 95 Zhang, 2023, Global, regional, and national burdens of cirrhosis in children and adolescents aged under 19 years from 1990 to 2019, Hepatol Int, 10.1007/s12072-023-10531-y Manne, 2014, Cirrhosis regression in patients with viral hepatitis B and C: a systematic review, J Clin Gastroenterol, 48, e76, 10.1097/MCG.0000000000000162 Reiberger, 2023, The Baveno VII concept of cirrhosis recompensation, Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver, 55, 431