CIRROSIS HEPÁTICA EN HOMBRES ADULTOS: UNA REVISIÓN INTEGRADORA
DOI:
https://doi.org/10.56238/arev8n3-049Palabras clave:
Cirrosis Hepática, Mortalidad, Descompensación Hepática, Inflamación Sistémica, PronósticoResumen
La cirrosis hepática es una enfermedad crónica y progresiva asociada a una alta morbilidad y mortalidad, especialmente en varones. Se caracteriza por cambios estructurales y funcionales en el hígado, que pueden progresar a eventos de descompensación, insuficiencia orgánica y muerte. Este estudio tuvo como objetivo analizar la evidencia científica sobre la cirrosis hepática en varones adultos, centrándose en los principales resultados clínicos y factores pronósticos. Se trata de una revisión bibliográfica integradora, realizada en las bases de datos PubMed/MEDLINE, SciELO, LILACS y Google Scholar, que abarca artículos publicados entre 2019 y 2026. Tras aplicar los criterios de inclusión y exclusión, 19 estudios conformaron la muestra final. Los hallazgos mostraron una alta mortalidad asociada a la cirrosis, particularmente en presencia de consumo de alcohol, insuficiencia renal aguda, infecciones, inflamación sistémica, sarcopenia y fragilidad. Se observó que la progresión de la enfermedad se relaciona no solo con la función hepática basal, sino también con la aparición de nuevos eventos de descompensación durante la hospitalización. Se concluye que la cirrosis hepática en hombres adultos debe entenderse como una enfermedad sistémica que requiere un enfoque clínico multidimensional e intervenciones tempranas para reducir las complicaciones y la mortalidad.
Descargas
Referencias
DONG, L.; XIAO, Y.; LI, Y.; HE, Y.; LIU, Y.; QI, X.; WANG, H. hs-cTnT and NT-ProBNP, rather than unspecified coronary artery disease, may be associated with further decompensation and death in liver cirrhosis. Digestive and Liver Disease, v. 57, n. 12, p. 2399–2409, 2025. DOI: 10.1016/j.dld.2025.09.019. DOI: https://doi.org/10.1016/j.dld.2025.09.019
EIFLER, L. M.; MOREIRA, T. R.; POSSEBON, J. P. P.; FERREIRA, L. F.; JOTZ, R. F.; MATTOS, Â. Z. Impact of sarcopenia on the prognosis of patients with cirrhosis hospitalized for acute decompensation or acute-on-chronic liver failure. Arquivos de Gastroenterologia, v. 61, e24069, 2024. DOI: 10.1590/S0004-2803.24612024-069. DOI: https://doi.org/10.1590/s0004-2803.24612024-069
FULLER, H.; TITTANEGRO, T. H.; MAINI, A. A.; CHINA, L.; RHODES, F.; BECARES SALLES, N.; MUKHOPADHYAY, S.; MOORE, B.; O’BRIEN, A. Hyperbilirubinemia at hospitalization predicts nosocomial infection in decompensated cirrhosis: data from ATTIRE trial. Hepatology Communications, v. 9, n. 4, e0648, 2025. DOI: 10.1097/HC9.0000000000000648. DOI: https://doi.org/10.1097/HC9.0000000000000648
HANAI, T.; NISHIMURA, K.; UNOME, S. et al. Alcohol-associated liver disease increases the risk of muscle loss and mortality in patients with cirrhosis. Journal of Gastroenterology, v. 59, p. 932–940, 2024. DOI: 10.1007/s00535-024-02137-4. DOI: https://doi.org/10.1007/s00535-024-02137-4
HARTL, L.; HINTERSTEININGER, M.; SIMBRUNNER, B. et al. The vasopressin biomarker copeptin is linked to systemic inflammation and refines prognostication in decompensated cirrhosis. Clinical Gastroenterology and Hepatology, v. 24, n. 1, p. 131–140, 2026. DOI: 10.1016/j.cgh.2025.04.030. DOI: https://doi.org/10.1016/j.cgh.2025.04.030
KABELITZ, M. A.; GAIRING, S. J.; TIEDE, A. et al. Impact of frailty on the prognosis of patients with liver cirrhosis undergoing insertion of a TIPS. Alimentary Pharmacology & Therapeutics, v. 63, n. 1, p. 109–118, 2026. DOI: 10.1111/apt.70315. DOI: https://doi.org/10.1111/apt.70315
KOSUTA, I.; BABEL, J.; DOMISLOVIC, V. et al. Clinical impact of multidrug-resistant organisms in liver cirrhosis: a retrospective cohort study in the intensive care setting. World Journal of Gastroenterology, v. 31, n. 39, p. 111261, 2025. DOI: 10.3748/wjg.v31.i39.111261. DOI: https://doi.org/10.3748/wjg.v31.i39.111261
LAN, Y.; YU, Y.; ZHANG, X. et al. Risk factors and prognostic impact of new decompensated events in hospitalized patients with decompensated cirrhosis. BMC Gastroenterology, v. 24, n. 1, p. 408, 2024. DOI: 10.1186/s12876-024-03494-3. DOI: https://doi.org/10.1186/s12876-024-03494-3
MIWA, T.; UTAKATA, Y.; HANAI, T. et al. Acute kidney injury development is associated with mortality in Japanese patients with cirrhosis: impact of amino acid imbalance. Journal of Gastroenterology, v. 59, p. 849–857, 2024. DOI: 10.1007/s00535-024-02126-7. DOI: https://doi.org/10.1007/s00535-024-02126-7
MO, R.; ZHANG, Z.; ZHOU, Y. et al. A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis. Lipids in Health and Disease, v. 24, n. 1, p. 35, 2025. DOI: 10.1186/s12944-025-02434-8. DOI: https://doi.org/10.1186/s12944-025-02434-8
PEARSON, M. M.; KIM, N. J.; BERRY, K. et al. Associations between alcohol use and liver-related outcomes in a large national cohort of patients with cirrhosis. Hepatology Communications, v. 5, n. 12, p. 2080–2095, 2021. DOI: 10.1002/hep4.1776. DOI: https://doi.org/10.1002/hep4.1776
SCHLEICHER, E. M.; KAPS, L.; SCHATTENBERG, J. M. et al. Higher scores in the Clinical Frailty Scale are associated with covert and overt hepatic encephalopathy in patients with cirrhosis. Digestive and Liver Disease, v. 56, n. 6, p. 1046–1053, 2024. DOI: 10.1016/j.dld.2023.12.001. DOI: https://doi.org/10.1016/j.dld.2023.12.001
SHIN, S. K.; YIM, H. J.; KIM, J. H. et al. Partial virological response after 2 years of entecavir therapy increases the risk of hepatocellular carcinoma in patients with hepatitis B virus-associated cirrhosis. Gut and Liver, v. 15, n. 3, p. 430–439, 2021. DOI: 10.5009/gnl20074. DOI: https://doi.org/10.5009/gnl20074
TIEDE, A.; STOCKHOFF, L.; LIU, Z. et al. Insertion of a transjugular intrahepatic portosystemic shunt leads to sustained reversal of systemic inflammation in patients with decompensated liver cirrhosis. Clinical and Molecular Hepatology, v. 31, n. 1, p. 240–255, 2025. DOI: 10.3350/cmh.2024.0587. DOI: https://doi.org/10.3350/cmh.2025.0135
VÉLEZ, J. L.; PÉREZ, A.; BLANCO, J. D. et al. Caracterización de los pacientes con cirrosis agudamente descompensada que consultaron a diferentes servicios de urgencias de alta complejidad en Medellín, Colombia. Biomédica, v. 43, supl. 3, p. 9–20, 2023.
WENTWORTH, B. J.; GENG, C. X.; NOVICOFF, W. M.; SIRAGY, H. M.; HENRY, Z. H. Adrenal dysfunction in outpatients with decompensated cirrhosis: impairment in the hypothalamic-pituitary-adrenal axis. Digestive Diseases and Sciences, v. 70, n. 12, p. 4247–4258, 2025. DOI: 10.1007/s10620-025-09237-y. DOI: https://doi.org/10.1007/s10620-025-09237-y
WONG, R. J.; JONES, P. D.; NIU, B. et al. Hepatocellular carcinoma surveillance in patients with cirrhosis at US safety-net health systems. Clinical and Translational Gastroenterology, v. 16, n. 8, e00877, 2025. DOI: 10.14309/ctg.0000000000000877. DOI: https://doi.org/10.14309/ctg.0000000000000877
YILMA, M.; KIM, N. J.; SHUI, A. M. et al. Factors associated with liver transplant referral among patients with cirrhosis at multiple safety-net hospitals. JAMA Network Open, v. 6, n. 6, e2317549, 2023. DOI: 10.1001/jamanetworkopen.2023.17549. DOI: https://doi.org/10.1001/jamanetworkopen.2023.17549
ZHANG, X.; ZHAO, L.; DAI, Q. et al. Blood magnesium level and risk of hepatocellular carcinoma in a prospective liver cirrhosis cohort. Cancer Epidemiology, Biomarkers & Prevention, v. 33, n. 10, p. 1368–1374, 2024. DOI: 10.1158/1055-9965.EPI-24-0327. DOI: https://doi.org/10.1158/1055-9965.EPI-24-0327
