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Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients

BACKGROUND/AIMS: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. METHODS: Cirrhosis patients...

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Autores principales: Jain, Priyanka, Shasthry, Saggere Muralikrishna, Choudhury, Ashok Kumar, Maiwall, Rakhi, Kumar, Guresh, Bharadwaj, Ankit, Arora, Vinod, Vijayaraghavan, Rajan, Jindal, Ankur, Sharma, Manoj Kumar, Bhatia, Vikram, Sarin, Shiv Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820216/
https://www.ncbi.nlm.nih.gov/pubmed/33317256
http://dx.doi.org/10.3350/cmh.2020.0068
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author Jain, Priyanka
Shasthry, Saggere Muralikrishna
Choudhury, Ashok Kumar
Maiwall, Rakhi
Kumar, Guresh
Bharadwaj, Ankit
Arora, Vinod
Vijayaraghavan, Rajan
Jindal, Ankur
Sharma, Manoj Kumar
Bhatia, Vikram
Sarin, Shiv Kumar
author_facet Jain, Priyanka
Shasthry, Saggere Muralikrishna
Choudhury, Ashok Kumar
Maiwall, Rakhi
Kumar, Guresh
Bharadwaj, Ankit
Arora, Vinod
Vijayaraghavan, Rajan
Jindal, Ankur
Sharma, Manoj Kumar
Bhatia, Vikram
Sarin, Shiv Kumar
author_sort Jain, Priyanka
collection PubMed
description BACKGROUND/AIMS: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. METHODS: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. RESULTS: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. CONCLUSIONS: One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age.
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spelling pubmed-78202162021-01-27 Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients Jain, Priyanka Shasthry, Saggere Muralikrishna Choudhury, Ashok Kumar Maiwall, Rakhi Kumar, Guresh Bharadwaj, Ankit Arora, Vinod Vijayaraghavan, Rajan Jindal, Ankur Sharma, Manoj Kumar Bhatia, Vikram Sarin, Shiv Kumar Clin Mol Hepatol Original Article BACKGROUND/AIMS: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. METHODS: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. RESULTS: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. CONCLUSIONS: One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age. The Korean Association for the Study of the Liver 2021-01 2020-12-03 /pmc/articles/PMC7820216/ /pubmed/33317256 http://dx.doi.org/10.3350/cmh.2020.0068 Text en Copyright © 2021 by The Korean Association for the Study of the Liver This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jain, Priyanka
Shasthry, Saggere Muralikrishna
Choudhury, Ashok Kumar
Maiwall, Rakhi
Kumar, Guresh
Bharadwaj, Ankit
Arora, Vinod
Vijayaraghavan, Rajan
Jindal, Ankur
Sharma, Manoj Kumar
Bhatia, Vikram
Sarin, Shiv Kumar
Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
title Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
title_full Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
title_fullStr Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
title_full_unstemmed Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
title_short Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
title_sort alcohol associated liver cirrhotics have higher mortality after index hospitalization: long-term data of 5,138 patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820216/
https://www.ncbi.nlm.nih.gov/pubmed/33317256
http://dx.doi.org/10.3350/cmh.2020.0068
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