Cirrhosis and Liver Failure
Hospital mortality over time in patients with specific complications of cirrhosis
Article first published online: 15 MAR 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 33, Issue 6, pages 828–833, July 2013
How to Cite
Liver Int. 2013: 33: 828–833
- Issue published online: 9 JUN 2013
- Article first published online: 15 MAR 2013
- Accepted manuscript online: 22 FEB 2013 10:13AM EST
- Manuscript Accepted: 7 FEB 2013
- Manuscript Received: 5 SEP 2012
- bacterial spontaneous peritonitis;
- hepatorenal syndrome;
- hospital mortality;
Hospital mortality secondary to cirrhosis is high.
To evaluate hospital mortality in patients admitted for specific complications of cirrhosis over time.
Material and methods
Registry-data from Administrative Inpatient Dataset of acute care hospitals were collected at discharge from 2003 to 2010. Inclusion criteria were as follows: hospital admissions where one of the diagnoses was cirrhosis and the reason for admission was a specific complication of cirrhosis (ascites, encephalopathy, hepatorenal syndrome and haemorrhage from varices, bacterial spontaneous peritonitis). Analysis of variance was used for comparisons of quantitative variables and Chi-square for qualitative variables. Logistic regression was performed to identify the risk factors associated with hospital mortality; the Hosmer and Lemeshow test was applied to evaluate calibration and the ROC curve for discrimination respectively.
A total of 12,671 hospital admissions were analysed; 67.7% were men. Mean hospitalization stay was 10.9 (SD 9.2) days and the most frequent causes were encephalopathy (44.2%) and ascites (30.9%). Global hospital mortality was 11.6%. Logistic regression showed that once all factors had been adjusted, hepatorenal syndrome conveyed the highest risk for death (49.2%; OR = 8.1(95%CI:6.6–9.9). Risk of death was also increased by associated comorbidities and older age. Hospital mortality in the period 2006–2010 was 27% inferior to the period 2003–2005. The area under the ROC curve (AUROC) was 0.77 (95%CI 0.76–0.78).
Hospital mortality as a result of specific complications of cirrhosis is high, but has been declining in recent years.