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The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis

Background: We aimed to determine whether septic patients with liver cirrhosis (LC) had worse survival than septic patients without liver cirrhosis (WLC). We also investigated the survival of septic patients with compensated liver cirrhosis (CLC) and decompensated liver cirrhosis (DLC). Methods: Thi...

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Autores principales: Chang, Ya-Chun, Fang, Ying-Tang, Chen, Hung-Cheng, Lin, Chiung-Yu, Chang, Yu-Ping, Tsai, Yi-Hsuan, Chen, Yu-Mu, Huang, Kuo-Tung, Chang, Huang-Chih, Wang, Chin-Chou, Lin, Meng-Chih, Fang, Wen-Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951259/
https://www.ncbi.nlm.nih.gov/pubmed/35329955
http://dx.doi.org/10.3390/jcm11061629
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author Chang, Ya-Chun
Fang, Ying-Tang
Chen, Hung-Cheng
Lin, Chiung-Yu
Chang, Yu-Ping
Tsai, Yi-Hsuan
Chen, Yu-Mu
Huang, Kuo-Tung
Chang, Huang-Chih
Wang, Chin-Chou
Lin, Meng-Chih
Fang, Wen-Feng
author_facet Chang, Ya-Chun
Fang, Ying-Tang
Chen, Hung-Cheng
Lin, Chiung-Yu
Chang, Yu-Ping
Tsai, Yi-Hsuan
Chen, Yu-Mu
Huang, Kuo-Tung
Chang, Huang-Chih
Wang, Chin-Chou
Lin, Meng-Chih
Fang, Wen-Feng
author_sort Chang, Ya-Chun
collection PubMed
description Background: We aimed to determine whether septic patients with liver cirrhosis (LC) had worse survival than septic patients without liver cirrhosis (WLC). We also investigated the survival of septic patients with compensated liver cirrhosis (CLC) and decompensated liver cirrhosis (DLC). Methods: This study enrolled 776 consecutive adult patients with sepsis admitted to the medical intensive care units of a tertiary referral hospital. Clinical factors and laboratory data were collected for analysis. Propensity scoring was also used for the control of selection bias. The variables included in the propensity model were age, sex, presence of diabetes mellitus, hypertension, cardiovascular accident, chronic kidney disease, malignancy, APCHE II (Acute Physiology and Chronic Health Evaluation) score, hemoglobin, and platelet data on the day when sepsis was confirmed. Seven-day, ICU, and hospital mortality were analyzed after correcting for these confounding factors. Results: Of the 776 septic patients, 64 (8.2%) septic patients presented with LC. Patients were divided into two groups—LC (n = 64) and WLC (n = 712)—which presented different rates of hospital mortality (LC: 62.5% vs. WLC: 41.0%, p = 0.001). We further separated septic patients with LC into two groups: patients with CLC (n = 24) and those with DLC (n = 40). After propensity score matching, the survival of septic patients with CLC (63.6%) was not inferior to patients WLC (54.5%) (p = 0.411). Patients with DLC had more hospital mortality, even after matching (p < 0.05). The Quick SOFA (qSOFA) score, SOFA score, and sub-SOFA score were also comparable between groups. SOFA scores were not significantly different between the CLC and WLC groups after matching. Poor SOFA scores were observed in the DLC group on days 3 and 7 after matching (p < 0.05). Conclusions: Septic patients with LC had higher mortality compared to patients WLC before matching. However, after propensity score matching, the survival of septic patients with CLC was non-inferior to patients WLC.
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spelling pubmed-89512592022-03-26 The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis Chang, Ya-Chun Fang, Ying-Tang Chen, Hung-Cheng Lin, Chiung-Yu Chang, Yu-Ping Tsai, Yi-Hsuan Chen, Yu-Mu Huang, Kuo-Tung Chang, Huang-Chih Wang, Chin-Chou Lin, Meng-Chih Fang, Wen-Feng J Clin Med Article Background: We aimed to determine whether septic patients with liver cirrhosis (LC) had worse survival than septic patients without liver cirrhosis (WLC). We also investigated the survival of septic patients with compensated liver cirrhosis (CLC) and decompensated liver cirrhosis (DLC). Methods: This study enrolled 776 consecutive adult patients with sepsis admitted to the medical intensive care units of a tertiary referral hospital. Clinical factors and laboratory data were collected for analysis. Propensity scoring was also used for the control of selection bias. The variables included in the propensity model were age, sex, presence of diabetes mellitus, hypertension, cardiovascular accident, chronic kidney disease, malignancy, APCHE II (Acute Physiology and Chronic Health Evaluation) score, hemoglobin, and platelet data on the day when sepsis was confirmed. Seven-day, ICU, and hospital mortality were analyzed after correcting for these confounding factors. Results: Of the 776 septic patients, 64 (8.2%) septic patients presented with LC. Patients were divided into two groups—LC (n = 64) and WLC (n = 712)—which presented different rates of hospital mortality (LC: 62.5% vs. WLC: 41.0%, p = 0.001). We further separated septic patients with LC into two groups: patients with CLC (n = 24) and those with DLC (n = 40). After propensity score matching, the survival of septic patients with CLC (63.6%) was not inferior to patients WLC (54.5%) (p = 0.411). Patients with DLC had more hospital mortality, even after matching (p < 0.05). The Quick SOFA (qSOFA) score, SOFA score, and sub-SOFA score were also comparable between groups. SOFA scores were not significantly different between the CLC and WLC groups after matching. Poor SOFA scores were observed in the DLC group on days 3 and 7 after matching (p < 0.05). Conclusions: Septic patients with LC had higher mortality compared to patients WLC before matching. However, after propensity score matching, the survival of septic patients with CLC was non-inferior to patients WLC. MDPI 2022-03-15 /pmc/articles/PMC8951259/ /pubmed/35329955 http://dx.doi.org/10.3390/jcm11061629 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chang, Ya-Chun
Fang, Ying-Tang
Chen, Hung-Cheng
Lin, Chiung-Yu
Chang, Yu-Ping
Tsai, Yi-Hsuan
Chen, Yu-Mu
Huang, Kuo-Tung
Chang, Huang-Chih
Wang, Chin-Chou
Lin, Meng-Chih
Fang, Wen-Feng
The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis
title The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis
title_full The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis
title_fullStr The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis
title_full_unstemmed The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis
title_short The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis
title_sort survival of septic patients with compensated liver cirrhosis is not inferior to that of septic patients without liver cirrhosis: a propensity score matching analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951259/
https://www.ncbi.nlm.nih.gov/pubmed/35329955
http://dx.doi.org/10.3390/jcm11061629
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