Abstract

BACKGROUND: The impact of liver cirrhosis on the outcomes of admission to intensive care unit (ICU) is not completely understood. Our purpose is to identify risk factors for mortality in ICU patients with liver cirrhosis. METHODS: Using reimbursement claims from Taiwan's National Health Insurance Research Database from in 2006-2012, 1,250,300 patients were identified as having ICU stays of more than 1 day, and 37,197 of these had liver cirrhosis. With propensity score-matching for socioeconomic status, pre-existing medical conditions, and cirrhosis-related morbidities, 37,197 ICU patients without liver cirrhosis were selected for comparison. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cirrhosis associated with 30-day, ICU, and one-year mortality were calculated. RESULTS: Compared with control, cirrhotic patients had higher 30-day mortality (aOR 1.60, 95% CI 1.53 to 1.68), particularly those with jaundice (aOR 2.23, 95% CI 2.03 to 2.45), ascites (aOR 2.32, 95% CI 2.19 to 2.46) or hepatic coma (aOR 2.21, 95% CI 2.07 to 2.36). Among ICU patients, liver cirrhosis was also associated with ICU mortality (aOR 144, 95% CI 1.38 to 1.51) and one-year mortality (aOR 1.40, 95% CI 1.35 to 1.46). Associations between cirrhosis of liver and increased 30-day mortality were significant in both sexes and every age group. CONCLUSIONS: Liver cirrhosis was associated with 30-day mortality in ICU patients. Jaundice, ascites, hepatic coma, more than 4 admissions due to cirrhosis, and more than 30 days of hospital stay due to cirrhosis were exacerbated factors in cirrhotic ICU patients.

Original languageEnglish
Number of pages1
JournalBMC Gastroenterology
Volume20
Issue number1
DOIs
Publication statusPublished - Jan 16 2020

Fingerprint

Liver Cirrhosis
Intensive Care Units
Cohort Studies
Mortality
Confidence Intervals
Population
Fibrosis
Hepatic Encephalopathy
Jaundice
Ascites
Propensity Score
Preexisting Condition Coverage
National Health Programs
Taiwan
Social Class
Length of Stay
Age Groups
Odds Ratio
Databases
Morbidity

Keywords

  • Intensive care unit
  • Liver cirrhosis
  • Mortality

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{09edbfd3ffb345c3be1664902672591f,
title = "A population-based cohort study of mortality of intensive care unit patients with liver cirrhosis",
abstract = "BACKGROUND: The impact of liver cirrhosis on the outcomes of admission to intensive care unit (ICU) is not completely understood. Our purpose is to identify risk factors for mortality in ICU patients with liver cirrhosis. METHODS: Using reimbursement claims from Taiwan's National Health Insurance Research Database from in 2006-2012, 1,250,300 patients were identified as having ICU stays of more than 1 day, and 37,197 of these had liver cirrhosis. With propensity score-matching for socioeconomic status, pre-existing medical conditions, and cirrhosis-related morbidities, 37,197 ICU patients without liver cirrhosis were selected for comparison. Adjusted odds ratios (ORs) and 95{\%} confidence intervals (CIs) of cirrhosis associated with 30-day, ICU, and one-year mortality were calculated. RESULTS: Compared with control, cirrhotic patients had higher 30-day mortality (aOR 1.60, 95{\%} CI 1.53 to 1.68), particularly those with jaundice (aOR 2.23, 95{\%} CI 2.03 to 2.45), ascites (aOR 2.32, 95{\%} CI 2.19 to 2.46) or hepatic coma (aOR 2.21, 95{\%} CI 2.07 to 2.36). Among ICU patients, liver cirrhosis was also associated with ICU mortality (aOR 144, 95{\%} CI 1.38 to 1.51) and one-year mortality (aOR 1.40, 95{\%} CI 1.35 to 1.46). Associations between cirrhosis of liver and increased 30-day mortality were significant in both sexes and every age group. CONCLUSIONS: Liver cirrhosis was associated with 30-day mortality in ICU patients. Jaundice, ascites, hepatic coma, more than 4 admissions due to cirrhosis, and more than 30 days of hospital stay due to cirrhosis were exacerbated factors in cirrhotic ICU patients.",
keywords = "Intensive care unit, Liver cirrhosis, Mortality",
author = "Huang, {Yu Feng} and Lin, {Chao Shun} and Cherng, {Yih Giun} and Yeh, {Chun Chieh} and Chen, {Ray Jade} and Chen, {Ta Liang} and Liao, {Chien Chang}",
year = "2020",
month = "1",
day = "16",
doi = "10.1186/s12876-020-1163-1",
language = "English",
volume = "20",
journal = "BMC Gastroenterology",
issn = "1471-230X",
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TY - JOUR

T1 - A population-based cohort study of mortality of intensive care unit patients with liver cirrhosis

AU - Huang, Yu Feng

AU - Lin, Chao Shun

AU - Cherng, Yih Giun

AU - Yeh, Chun Chieh

AU - Chen, Ray Jade

AU - Chen, Ta Liang

AU - Liao, Chien Chang

PY - 2020/1/16

Y1 - 2020/1/16

N2 - BACKGROUND: The impact of liver cirrhosis on the outcomes of admission to intensive care unit (ICU) is not completely understood. Our purpose is to identify risk factors for mortality in ICU patients with liver cirrhosis. METHODS: Using reimbursement claims from Taiwan's National Health Insurance Research Database from in 2006-2012, 1,250,300 patients were identified as having ICU stays of more than 1 day, and 37,197 of these had liver cirrhosis. With propensity score-matching for socioeconomic status, pre-existing medical conditions, and cirrhosis-related morbidities, 37,197 ICU patients without liver cirrhosis were selected for comparison. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cirrhosis associated with 30-day, ICU, and one-year mortality were calculated. RESULTS: Compared with control, cirrhotic patients had higher 30-day mortality (aOR 1.60, 95% CI 1.53 to 1.68), particularly those with jaundice (aOR 2.23, 95% CI 2.03 to 2.45), ascites (aOR 2.32, 95% CI 2.19 to 2.46) or hepatic coma (aOR 2.21, 95% CI 2.07 to 2.36). Among ICU patients, liver cirrhosis was also associated with ICU mortality (aOR 144, 95% CI 1.38 to 1.51) and one-year mortality (aOR 1.40, 95% CI 1.35 to 1.46). Associations between cirrhosis of liver and increased 30-day mortality were significant in both sexes and every age group. CONCLUSIONS: Liver cirrhosis was associated with 30-day mortality in ICU patients. Jaundice, ascites, hepatic coma, more than 4 admissions due to cirrhosis, and more than 30 days of hospital stay due to cirrhosis were exacerbated factors in cirrhotic ICU patients.

AB - BACKGROUND: The impact of liver cirrhosis on the outcomes of admission to intensive care unit (ICU) is not completely understood. Our purpose is to identify risk factors for mortality in ICU patients with liver cirrhosis. METHODS: Using reimbursement claims from Taiwan's National Health Insurance Research Database from in 2006-2012, 1,250,300 patients were identified as having ICU stays of more than 1 day, and 37,197 of these had liver cirrhosis. With propensity score-matching for socioeconomic status, pre-existing medical conditions, and cirrhosis-related morbidities, 37,197 ICU patients without liver cirrhosis were selected for comparison. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cirrhosis associated with 30-day, ICU, and one-year mortality were calculated. RESULTS: Compared with control, cirrhotic patients had higher 30-day mortality (aOR 1.60, 95% CI 1.53 to 1.68), particularly those with jaundice (aOR 2.23, 95% CI 2.03 to 2.45), ascites (aOR 2.32, 95% CI 2.19 to 2.46) or hepatic coma (aOR 2.21, 95% CI 2.07 to 2.36). Among ICU patients, liver cirrhosis was also associated with ICU mortality (aOR 144, 95% CI 1.38 to 1.51) and one-year mortality (aOR 1.40, 95% CI 1.35 to 1.46). Associations between cirrhosis of liver and increased 30-day mortality were significant in both sexes and every age group. CONCLUSIONS: Liver cirrhosis was associated with 30-day mortality in ICU patients. Jaundice, ascites, hepatic coma, more than 4 admissions due to cirrhosis, and more than 30 days of hospital stay due to cirrhosis were exacerbated factors in cirrhotic ICU patients.

KW - Intensive care unit

KW - Liver cirrhosis

KW - Mortality

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U2 - 10.1186/s12876-020-1163-1

DO - 10.1186/s12876-020-1163-1

M3 - Article

C2 - 31948392

AN - SCOPUS:85077997954

VL - 20

JO - BMC Gastroenterology

JF - BMC Gastroenterology

SN - 1471-230X

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