Outcomes and factors associated with cryptococcal disease among cirrhotics: A study of the national inpatient sample 2005 to 2014 - 14/04/24
Highlights |
• | The geographical location and CKD were important factors associated with CD among cirrhotic patients. |
• | Autoimmune liver diseases and immunosuppression did not appear to increase the risk of CD. |
• | Cirrhotic patients with CD had significantly worse outcomes as compared to cirrhotic patients without CD include higher inpatient mortality, higher probability of discharge to a facility or with home health care, a longer length of stay, and a higher total charge. |
Abstract |
Background |
Cryptococcal disease (CD) confers a higher mortality in cirrhotic patients compared to non-cirrhotic patients. Factor association for CD in cirrhotic patients is poorly understood. Our aim was to determine the incidence, demographic, and comorbidities associated with CD among cirrhotic patients in the United States (US).
Method |
Retrospective analysis of admissions of cirrhotic patients, with or without CD, using the National Inpatient Sample (NIS) database from 2005 to 2014. The number of admissions were reported in raw and weighted frequencies. The trends of CD among cirrhotic patients and overall CD were evaluated. Rao-Scott chi-square, t-tests, and multivariate logistic regressions were performed to evaluate variables and CD among cirrhotic patients.
Results |
There were 886,962 admissions for cirrhosis, and 164 of these with CD. By adjusted odds ratio (AOR), CD was more often associated with cirrhosis in Southern (2.95; 95 % CI 1.24, 7.02) and Western regions (4.45; 95 % CI 1.91, 10.37), Hispanic patients (1.80; 95 % CI 1.01, 3.20), and patients with chronic kidney disease (CKD) (3.13; 95 % CI 2.09, 4.69). Of note, CD in cirrhotic patients was associated with higher inpatient mortality (AOR of 3.89, 95 % CI 2.53, 5.99), longer length of stay (9.87 vs. 4.88 days), and a higher total charge ($76,880 vs. $ 37,227) when compared to cirrhotic patients without CD.
Discussion |
Patients with cirrhosis admitted with CD have a high inpatient mortality. The geographical location and CKD were important factors associated with CD among cirrhotic patients. Autoimmune liver diseases and immunosuppression did not appear to increase the risk of CD.
Le texte complet de cet article est disponible en PDF.Keywords : Cirrhosis, Cryptococcus, Mortality, Outcomes, Cohort
Plan
☆ | Meeting information: This article was presented as an abstract for the American Association for the Study of Liver Disease (AASLD) annual meeting in Anaheim, California, USA, November 2021. |
Authorship: All authors listed contributed substantially to the design of work, analysis, and interpretation of data, with input during drafting and final review of the version to be published. All authors agree to be accountable for all aspects of work. |
Vol 48 - N° 5
Article 102337- mai 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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