Complications Requiring Hospital Admission and Causes of In-Hospital Death over Time in Alcoholic and Nonalcoholic Cirrhosis Patients

Abstract

Background/AimsData on the epidemiology of alcoholic cirrhosis, especially in Asian countries, are limited. We compared the temporal evolution of patterns of alcoholic and nonalcoholic cirrhosis over the last decade.MethodsWe retrospectively examined the inpatient datasets of five referral centers during 2002 and 2011. The study included patients who were admitted due to specific complications of liver cirrhosis. We compared the causes of hospital admissions and in-hospital deaths between patients with alcoholic and nonalcoholic cirrhosis.ResultsAmong the included 2,799 hospitalizations (2,165 patients), 1,496 (1,143 patients) were from 2002, and 1,303 (1,022 patients) were from 2011. Over time, there was a reduction in the rate of hepatic encephalopathy (HE) as a cause of hospitalization and an increase in the rate of hepatocellular carcinoma. Deaths that were attributable to HE or spontaneous bacterial peritonitis (SBP) significantly decreased, whereas those due to hepatorenal syndrome (HRS) significantly increased over time in patients with alcoholic cirrhosis. However, in patients with nonalcoholic cirrhosis, hepatic failure and HRS remained the principal causes of in-hospital death during both time periods.ConclusionsThe major causes of in-hospital deaths have evolved from acute cirrhotic complications, including HE or SBP to HRS in alcoholic cirrhosis, whereas those have remained unchanged in nonalcoholic cirrhosis during the last decade.

Impact of Cirrhosis on Resource Use and Inpatient Complications in Patients Undergoing Total Knee and Hip Arthroplasty

“…Alcohol-related cirrhosis causes a stronger inflammatory response resulting in problems controlling the immune system, compared to viral-related cirrhosis[26]. Among patients who were hospitalized due to complications of cirrhosis, alcohol-related cirrhosis was the predominant cause[27]. Alcohol misuse in patients undergoing TJA has been previously reported and was shown to be a significant risk factor for poor outcomes following TJA along with increased LOS[28].…”

Place of death and factors associated with hospital death in patients who have died from liver disease in England: a national population-based study

“…During these years, some of the complications caused by end-stage liver disease had been better treated and were less likely to cause in-hospital death, such as: variceal bleeding, hepatic encephalopathy, ascites, and spontaneous bacterial peritonitis. However, hepatorenal syndrome was still difficult to be treated and accounted for 34.7% of the causes of in-hospital death in 2011 (16•9% in 2002) (49). As illustrated in our study, those who had hepatorenal syndrome as their contributory cause of death were constantly and highly likely (>90%) to die in hospital over this 14year period.…”

The evaluation of non‐invasive multi‐slice spiral computed tomography‐based indices for the diagnosis and prognosis prediction of liver cirrhosis

“…Liver cirrhosis, a chronic disease caused by various types of liver injury, can lead to liver failure and complications including ascites, hepatic encephalopathy, variceal bleeding, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatocellular carcinoma . Patients with decompensated cirrhosis have high mortality rates and this disease is a severe public health problem worldwide …”

“…1 Patients with decompensated cirrhosis have high mortality rates and this disease is a severe public health problem worldwide. 2,3 Liver biopsy remains gold standard of evaluating the severity of liver cirrhosis. 4 However, due to a high risk of bleeding, biopsy may not be widely used in patients with cirrhosis.…”