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Open Access 01-12-2024 | Cardiopulmonary Resuscitation | Research

Critical care outcomes in decompensated cirrhosis: a United States national inpatient sample cross-sectional study

Authors: Spencer R. Goble, Abdellatif S. Ismail, Jose D. Debes, Thomas M. Leventhal

Published in: Critical Care | Issue 1/2024

Abstract

Background

Prior assessments of critical care outcomes in patients with cirrhosis have shown conflicting results. We aimed to provide nationwide generalizable results of critical care outcomes in patients with decompensated cirrhosis.

Methods

This is a retrospective study using the National Inpatient Sample from 2016 to 2019. Adults with cirrhosis who required respiratory intubation, central venous catheter placement or both (n = 12,945) with principal diagnoses including: esophageal variceal hemorrhage (EVH, 24%), hepatic encephalopathy (58%), hepatorenal syndrome (HRS, 14%) or spontaneous bacterial peritonitis (4%) were included. A comparison cohort of patients without cirrhosis requiring intubation or central line placement for any principal diagnosis was included.

Results

Those with cirrhosis were younger (mean 58 vs. 63 years, p < 0.001) and more likely to be male (62% vs. 54%, p < 0.001). In-hospital mortality was higher in the cirrhosis cohort (33.1% vs. 26.6%, p < 0.001) and ranged from 26.7% in EVH to 50.6% HRS. Mortality when renal replacement therapy was utilized (n = 1580, 12.2%) was 46.5% in the cirrhosis cohort, compared to 32.3% in other hospitalizations (p < 0.001), and was lowest in EVH (25.7%) and highest in HRS (51.5%). Mortality when cardiopulmonary resuscitation was used was increased in the cirrhosis cohort (88.0% vs. 72.1%, p < 0.001) and highest in HRS (95.7%).

Conclusions

One-third of patients with cirrhosis requiring critical care did not survive to discharge in this U.S. nationwide assessment. While outcomes were worse than in patients without cirrhosis, the results do suggest better outcomes compared to previous studies.

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Title: Critical care outcomes in decompensated cirrhosis: a United States national inpatient sample cross-sectional study
Authors: Spencer R. Goble
Abdellatif S. Ismail
Jose D. Debes
Thomas M. Leventhal
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Cardiopulmonary Resuscitation
Hepatorenal Syndrome
Hepatorenal Syndrome
Hepatic Encephalopathy
Hepatic Encephalopathy
Central Venous Catheter
Published in: Critical Care / Issue 1/2024
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-024-04938-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Critical care outcomes in decompensated cirrhosis: a United States national inpatient sample cross-sectional study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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