Factors associated with mortality in patients with cirrhosis.

Introduction and Objectives

Chronic liver disease is increasingly prevalent, the causes range from MAFLD, alcohol consumption, HCV, autoimmune disease, and others. They develop complications such as: portal hypertension with esophageal and gastric varices, hepatic encephalopathy, ascites, renal injury, among others, conditioning the final stage of the disease and death; therefore, knowing the factor that has the greatest impact on mortality is relevant. To evaluate which decompensations are associated with higher mortality in patients with cirrhosis of different etiologies.

Materials and Patients

Retrospective, analytical, observational study of patients with cirrhosis. To determine the factors associated with 28- and 90-day mortality, proportional hazard curves were performed for COX with encephalopathy, gastrointestinal bleeding, ascites, renal injury, ACLF and infection, with absence of the factor as reference. Considering significant α ≤0.05, SPSS-V 25.0 was used

Results

200 patients, men 53%, women 47%. Etiology: alcohol 86, MAFLD 58, autoimmune 27, dual 16 and HCV 13; 37 died at 28 days and 49 at 90 days. Cumulative mortality rate 28 days 18.4%, 90 days 24.4%, with CHI square test for the model was significant, 109.34 (10), p<0.001, being significant with WALD statistic for ACLF with OR of 4.78 (1.24-18.37;95%IC), p=0.023 for 90 days, the model was significant CHI square 118.22 (10), p<0. 001, being significant encephalopathy grade 2 OR of 11.95 (1.49-57.16;95%IC) p= 0.02, ascites OR 2.63 (1.24-5.58;95%IC) p=0.12, acute kidney injury OR 4.02 (1. 16-13.88;95%IC) p=0.28, ACLF grade 2 OR 2.73 (1.001-7.43;95%IC) p=0.05, ACLF grade-3 OR 5.94 (1.83-19.2;95%IC) p=0.03, and infection OR 1.96 (1.014-3.79;95%IC) p=0.45

Conclusions

In our study group, the factors associated with mortality were the degree of ACLF, greater degree of encephalopathy and development of renal failure, with HD standing out with an OR of 11.95.

Ethical statement

The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.

Declaration of interests

None

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Figure 1. ACLF grade and its relationship with 90-day mortality

Figure 2. Main decompensations in patients with cirrhosis