Hospital mortality over time in patients with specific complications of cirrhosis. (15th March 2013)

• Record Type: Journal Article
• Authors: Vergara, Mercedes; Clèries, Montse; Vela, Emili; Bustins, Montserrat; Miquel, Mireia; Campo, Rafael
• Is Part Of: Liver international. Volume 33:Number 6(2013:Jul.)
• Page Start: 828
• Page End: 833
• Publication Date: 2013-03-15
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12137
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12137-abs-0001"> <title>Abstract</title> <sec id="liv12137-sec-0001" sec-type="section"> <p>Hospital mortality secondary to cirrhosis is high.</p> </sec> <sec id="liv12137-sec-0002" sec-type="section"> <title>Aim</title> <p>To evaluate hospital mortality in patients admitted for specific complications of cirrhosis over time.</p> </sec> <sec id="liv12137-sec-0003" sec-type="section"> <title>Material and methods</title> <p>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.</p> </sec> <sec id="liv12137-sec-0004" sec-type="section"> <title>Results</title> <p>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).</p> </sec> <sec id="liv12137-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Hospital mortality as a result of specific complications of cirrhosis is high, but has been declining in recent years.</p> </sec> </abstract>