P-105 RISK FACTORS FOR MORTALITY IN PATIENTS WITH DECOMPENSATED CIRRHOSIS DURING HOSPITALIZATION

Conflict of interest

No

Introduction and Objectives

Cirrhosis is a highly prevalent disease, classified into compensated, decompensated, and advanced stages. The risk of death is higher in patients with decompensated and advanced cirrhosis. Various risk factors are associated with mortality. Objective: To determine the main risk factors for mortality in patients with decompensated cirrhosis in the gastroenterology service of the General Hospital “Dr. Eduardo Liceaga”.

Patients / Materials and Methods

This is an observational, longitudinal, prospective, and analytical study in a cohort of patients with cirrhosis of various etiologies, with and without acute kidney injury (AKI), who were hospitalized during 2022 and followed up to the present date (2024). Patients who were lost to follow-up or diagnosed with hepatocellular carcinoma were excluded. Data was analyzed using SPSS version 23. Qualitative variables were reported as frequencies and percentages, while numerical variables were presented as means and standard deviations or medians and ranges, depending on their distribution. Multivariable analysis was performed using logistic regression to calculate adjusted odds ratios (OR) for each predictive factor. A p-value < 0.05 was considered statistically significant

Results and Discussion

A total of 110 patients with cirrhosis were included, 54 men (49%) with a mean age of 54 ± 8 years, and 56 women (51%) with a mean age of 56 ± 9.7 years. The most frequent etiology of cirrhosis was MASLD (41%), followed by alcohol (39%), with 10 patients having alcohol-induced hepatitis (9%). The Child-Pugh classification distribution was: A: 12 patients (11%), B: 40 patients (36%), and C: 58 patients (53%). Additionally, 37 patients presented ACLF (34%). During follow-up, 28 patients died during hospitalization and 49 within 24 months, with an overall mortality rate of 44.5%. Among the patients, 56 (45%) developed AKI, of which 44 (36%) had a prior episode. Additionally, 25 patients (20%) had an infection at admission or during hospitalization, and 28 (22%) experienced shock. The results showed that AKI and shock during hospitalization were the most significant factors. Shock during hospitalization had an OR of 3.886 (95% CI: [1.928, 7.835]), p < 0.001, and AKI an OR of 3.540 (95% CI: [1.767, 7.092]), p < 0.001, with a significant model according to the Chi-square test (x2 = 46.6, p < 0.0001). (Figure 1)

Conclusions

AKI and shock during hospitalization are significant predictive factors of mortality at two years. Early recognition and management of these factors are crucial to improve patient outcomes.