Retrospective Analyses of the Outcomes Among Hospitalized Liver Cirrhosis Patients, Including Those With COVID-19 Infection

Document Type

Conference Proceeding

Publication Date

10-1-2023

Publication Title

Am J Gastroenterol

Abstract

Introduction: Liver cirrhosis (LC) patients are at a higher risk of adverse events associated with Coronavirus disease 2019 (COVID-19). However, studies, especially large population-based reports of the impact of COVID-19 on patients hospitalized with cirrhosis, are limited. Methods: The National Inpatient Sample database was used for a retrospective analysis of patients with liver cirrhosis admitted during 2020 in the United States (US), with and without a diagnosis of COVID-19, based on International Classification of Diseases- 10th Edition (ICD-10)-CM. We investigated the outcomes of hospitalized LC patients with and without COVID-19 infection, looking at its impact on in-hospital mortality, the risk for acute kidney injury (AKI), and length of stay (LOS). A multivariable logistic regression analysis included various independent variables, including age, sex, race, comorbidities, in-hospital complications, socioeconomic factors, primary expected payer, hospital region, relative bed size category, and location/teaching status of the hospital. The analysis results are presented as adjusted odds ratios (AOR) with corresponding 95% confidence intervals (CI) and P-values to assess the significance of each factor. Results: Our database of inpatient admissions in 2020 included 6,471,165 patients, of which 157,421 (2.4%) had a diagnosis of LC. Of those with LC, 5197 (3.3%) were also diagnosed with COVID-19. COVID-19-positive LC patients had a higher prevalence of hyponatremia (27.3%). Most importantly, COVID-19-positive LC patients were found to have a significantly higher mortality rate during hospitalization (19.4%) compared to COVID-19-negative patients (6.1%). Multivariable logistic regression models showed that age at admission was significantly associated with inpatient mortality among LC patients (P < 0.001). For each year increase in age, the odds of mortality increased by approximately 1.9%. Several comorbidities were significantly associated with inpatient mortality. Notable factors with increased odds of mortality in LC patients included malnutrition (AOR: 1.424, P < 0.001), COVID-19 (AOR: 3.883, P < 0.001), and acute kidney injury (AOR: 6.067, P < 0.001). Conclusion: Concomitant COVID-19 infection among hospitalized LC patients was associated with a higher risk for in-hospital mortality. COVID-19-positive LC patients had a higher prevalence of hyponatremia. Several comorbidities were significantly associated with inpatient mortality. Notable factors with increased odds of mortality in LC patients included malnutrition, COVID-19, and AKI (Table 1).

Volume

118

Issue

10

First Page

S1027

Last Page

S1028

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