Abstracts of the 2023 Annual Meeting of the ALEH
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Introduction and ObjectivesDecompensated cirrhosis (DC) is an important cause of death worldwide, including in Latin America. This study aimed to evaluate in-hospital and 30-day post-discharge mortality in a multinational cohort in Latin America.
Patients / Materials and MethodsNon-elective cirrhosis admissions from Nov 2021 to Aug 2022 in sites from Mexico, Brazil, Argentina and Chile were included. Demographics, admission medications, prior conditions, etiology, and other data around admission were collected from patients and their medical records. Continuous variables were summarized using mean (± SD), and categorical variables as counts (%). Main outcomes were inpatient mortality/hospice and 30-day post-discharge mortality. Univariable comparisons were compared between outcomes using two-sample t-tests or chi-squared tests as appropriate. Multivariable models controlling for all variables significantly associated with outcomes at the p < 0.05 level were fit.
Results and DiscussionOf 651 patients with valid inpatient outcomes, 158 died in-hospital or were moved to hospice (24.3%). At 30-days, 139 were lost to follow-up, leaving 512 patients. Of these, 172 died by 30 days (33.6%). In-hospital and 30-days mortality were not affected by etiology (HBV, HCV, MASLD, crypto). Variables significantly associated with mortality at both timepoints were prior LVP/HE, admission medications, prior infection, liver-related admission, and higher MELD-Na (Table 1). On multivariable analysis, admission betablockers and lactulose were associated with high mortality; MELD-Na and infection on admission were associated to death at both timepoints (Table 2)
ConclusionsDC is associated with significant in-patient and 30-day mortality in the region, regardless of etiology and country, especially in patients with higher MELD-Na and/or infected on admission.