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A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19
BACKGROUND AND AIM: A few recent studies identified cirrhosis as a risk factor for high mortality in patients with coronavirus disease-19 (COVID-19). Palliative care is less often involved in the management of cirrhosis. We analyzed a global multicenter database to study the risk of mortality and pa...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Whioce Publishing Pte. Ltd.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536185/ https://www.ncbi.nlm.nih.gov/pubmed/36212699 |
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author | Thandassery, Ragesh B. Sharma, Shakshi Syed, Mahanazzudin Perisetti, Abhilash |
author_facet | Thandassery, Ragesh B. Sharma, Shakshi Syed, Mahanazzudin Perisetti, Abhilash |
author_sort | Thandassery, Ragesh B. |
collection | PubMed |
description | BACKGROUND AND AIM: A few recent studies identified cirrhosis as a risk factor for high mortality in patients with coronavirus disease-19 (COVID-19). Palliative care is less often involved in the management of cirrhosis. We analyzed a global multicenter database to study the risk of mortality and palliative care referrals in patients with COVID-19 and cirrhosis. METHODS: A federated cloud-based network (TriNetX) data from 50 health-care organizations across the globe were analyzed retrospectively. Patients with COVID-19 aged from 18 years to 90 years were identified between January 20, 2020, and November 16, 2020. RESULTS: A total of 1969 patients (Group A) with COVID-19 and cirrhosis and 169,257 patients with COVID-19 alone (Group B) were studied. The two groups had a similar occurrence of other comorbid diseases. In a propensity-matched analysis, the mortality rate in Group A (8.9%) was significantly higher than Group B (5.6%), hazard ratio (95% confidence interval) for mortality with cirrhosis was 1.59 (1.26–1.99) (P = 0.01). The occurrence of palliative care referrals in Group A (4.1%) was significantly higher than Group B (2.0%), hazard ratio (95% confidence interval) with cirrhosis was 2.02 (1.39–2.94) (P = 0.01). CONCLUSION: Mortality rate and palliative care referrals were higher in patients with cirrhosis and COVID-19 compared to those with COVID-19 alone. This increased occurrence of palliative care referrals compared to the general trend in cirrhotic patients probably indicates increased awareness of COVID-19 as a life-threatening condition. RELEVANCE FOR PATIENTS: Cirrhosis should be identified as a high-risk condition that may require palliative care referral in hospitalized patients with COVID-19. Hospital resource utilization and cost-analysis modeling should anticipate the need for palliative care referrals as a significant outcome in patients with cirrhosis who are hospitalized with COVID-19. |
format | Online Article Text |
id | pubmed-9536185 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Whioce Publishing Pte. Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95361852022-10-07 A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 Thandassery, Ragesh B. Sharma, Shakshi Syed, Mahanazzudin Perisetti, Abhilash J Clin Transl Res Original Article BACKGROUND AND AIM: A few recent studies identified cirrhosis as a risk factor for high mortality in patients with coronavirus disease-19 (COVID-19). Palliative care is less often involved in the management of cirrhosis. We analyzed a global multicenter database to study the risk of mortality and palliative care referrals in patients with COVID-19 and cirrhosis. METHODS: A federated cloud-based network (TriNetX) data from 50 health-care organizations across the globe were analyzed retrospectively. Patients with COVID-19 aged from 18 years to 90 years were identified between January 20, 2020, and November 16, 2020. RESULTS: A total of 1969 patients (Group A) with COVID-19 and cirrhosis and 169,257 patients with COVID-19 alone (Group B) were studied. The two groups had a similar occurrence of other comorbid diseases. In a propensity-matched analysis, the mortality rate in Group A (8.9%) was significantly higher than Group B (5.6%), hazard ratio (95% confidence interval) for mortality with cirrhosis was 1.59 (1.26–1.99) (P = 0.01). The occurrence of palliative care referrals in Group A (4.1%) was significantly higher than Group B (2.0%), hazard ratio (95% confidence interval) with cirrhosis was 2.02 (1.39–2.94) (P = 0.01). CONCLUSION: Mortality rate and palliative care referrals were higher in patients with cirrhosis and COVID-19 compared to those with COVID-19 alone. This increased occurrence of palliative care referrals compared to the general trend in cirrhotic patients probably indicates increased awareness of COVID-19 as a life-threatening condition. RELEVANCE FOR PATIENTS: Cirrhosis should be identified as a high-risk condition that may require palliative care referral in hospitalized patients with COVID-19. Hospital resource utilization and cost-analysis modeling should anticipate the need for palliative care referrals as a significant outcome in patients with cirrhosis who are hospitalized with COVID-19. Whioce Publishing Pte. Ltd. 2022-09-13 /pmc/articles/PMC9536185/ /pubmed/36212699 Text en Copyright: © 2022 Author(s). https://creativecommons.org/licenses/by-nc/4.0/This is an Open-Access article distributed under the terms of the Creative Commons Attribution-Noncommercial License, permitting all noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Thandassery, Ragesh B. Sharma, Shakshi Syed, Mahanazzudin Perisetti, Abhilash A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 |
title | A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 |
title_full | A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 |
title_fullStr | A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 |
title_full_unstemmed | A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 |
title_short | A global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with COVID-19 |
title_sort | global multicenter propensity-matched analysis of mortality risk and palliative care referral due to cirrhosis in hospitalized patients with covid-19 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536185/ https://www.ncbi.nlm.nih.gov/pubmed/36212699 |
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