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Erschienen in: Digestive Diseases and Sciences 1/2021

25.02.2020 | Original Article

MELD–Na Is More Strongly Associated with Risk of Infection and Outcomes Than Other Characteristics of Patients with Cirrhosis

verfasst von: Zachary P. Fricker, V. V. Pavan Kedar Mukthinuthalapati, Samuel Akinyeye, Naga Chalasani, Bashar M. Attar, Maya Balakrishnan, Marwan Ghabril, Michelle T. Long

Erschienen in: Digestive Diseases and Sciences | Ausgabe 1/2021

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Abstract

Background and Aims

The nature and outcomes of infection among patients with cirrhosis in safety-net hospitals are not well described. We aimed to characterize the rate of and risk factors for infection, both present on admission and nosocomial, in this unique population. We hypothesized that infections would be associated with adverse outcomes such as short-term mortality.

Methods

We used descriptive statistics to characterize infections within a retrospective cohort characterized previously. We used multivariable logistic regression models to assess potential risk factors for infection and associations with key outcomes such as short-term mortality and length of stay.

Results

The study cohort of 1112 patients included 33% women with a mean age of 56 ± 10 years. Infections were common (20%), with respiratory and urinary tract infections the most frequent. We did not observe a difference in the incidence of infection on admission based on patient demographic factors such as race/ethnicity or estimated household income. Infections on admission were associated with greater short-term mortality (12% vs 4% in-hospital and 14% vs 7% 30-day), longer length of stay (6 vs 3 days), intensive care unit admission (28% vs 18%), and acute-on-chronic liver failure (10% vs 2%) (p < 0.01 for all). Nosocomial infections were relatively uncommon (4%), but more frequent among patients admitted to the intensive care unit. Antibiotic resistance was common (38%), but not associated with negative outcomes.

Conclusion

We did not identify demographic risk factors for infection, but did confirm its morbid effect among patients with cirrhosis in safety-net hospitals.
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Metadaten
Titel
MELD–Na Is More Strongly Associated with Risk of Infection and Outcomes Than Other Characteristics of Patients with Cirrhosis
verfasst von
Zachary P. Fricker
V. V. Pavan Kedar Mukthinuthalapati
Samuel Akinyeye
Naga Chalasani
Bashar M. Attar
Maya Balakrishnan
Marwan Ghabril
Michelle T. Long
Publikationsdatum
25.02.2020
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 1/2021
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-020-06164-y

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