Hospital mortality over time in patients with specific complications of cirrhosis.
Liver Int. 2013 Jul;33(6):828-33
Authors: Vergara M, Clèries M, Vela E, Bustins M, Miquel M, Campo R
UNLABELLED: Hospital mortality secondary to cirrhosis is high.
AIM: To evaluate hospital mortality in patients admitted for specific complications of cirrhosis over time.
MATERIAL AND METHODS: Registry-data from Administrative Inpatient Dataset of acute care hospitals were collected at discharge from 2003 to 2010. Inclusion criteria were as follows: hospital admissions where one of the diagnoses was cirrhosis and the reason for admission was a specific complication of cirrhosis (ascites, encephalopathy, hepatorenal syndrome and haemorrhage from varices, bacterial spontaneous peritonitis). Analysis of variance was used for comparisons of quantitative variables and Chi-square for qualitative variables. Logistic regression was performed to identify the risk factors associated with hospital mortality; the Hosmer and Lemeshow test was applied to evaluate calibration and the ROC curve for discrimination respectively.
RESULTS: A total of 12,671 hospital admissions were analysed; 67.7% were men. Mean hospitalization stay was 10.9 (SD 9.2) days and the most frequent causes were encephalopathy (44.2%) and ascites (30.9%). Global hospital mortality was 11.6%. Logistic regression showed that once all factors had been adjusted, hepatorenal syndrome conveyed the highest risk for death (49.2%; OR = 8.1(95%CI:6.6-9.9). Risk of death was also increased by associated comorbidities and older age. Hospital mortality in the period 2006-2010 was 27% inferior to the period 2003-2005. The area under the ROC curve (AUROC) was 0.77 (95%CI 0.76-0.78).
CONCLUSIONS: Hospital mortality as a result of specific complications of cirrhosis is high, but has been declining in recent years.
PMID: 23496284 [PubMed - indexed for MEDLINE]