Retrospective Analyses of the Outcomes Among Hospitalized Liver Cirrhosis Patients, Including Those With COVID-19 Infection
Recommended Citation
Patel P, Yasin Z, Zreik H, Singh H, Singh B, Hari P, Karagozian R. Retrospective Analyses of the Outcomes Among Hospitalized Liver Cirrhosis Patients, Including Those With COVID-19 Infection. Am J Gastroenterol 2023; 118(10):S1027-S1028.
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