2013-01-15 15:02:35 UTC

Secondary Infections Increase Mortality in Hospitalized Patients With Cirrhosis

Jan. 17, 2013

The results of a prospective, cohort study of patients with cirrhosis with infections at eight North American tertiary-care hepatology centers performed by Bajaj et al. and found in Hepatology, show that potentially preventable second infections are predictors of mortality independent of liver disease severity.

Bacterial infections are an important cause of mortality in cirrhosis, but there is a paucity of multicenter studies. Bajaj et al. performed a prospective, cohort study of patients with cirrhosis with infections at eight North American tertiary-care hepatology centers. The results, found in Hepatology, show that 24 percent of patients who died within 30 days had higher admission model for endstage liver disease (MELD), lower serum albumin and second infections, but equivalent sequential organ failure (SOFA) scores. The team observed that the case fatality rate was highest for C. difficile, respiratory and spontaneous bacteremia, and lowest for spontaneous bacterial peritonitis and urinary infections. The researchers noted that model for mortality included admission MELD, heart rate, albumin and second infection as significant variables. Dr Bajaj's team concludes that "potentially preventable second infections are predictors of mortality independent of liver disease severity in this multicenter cirrhosis cohort."

Hepatology 2012: 56(6): 2328-2335

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