High mortality of pneumonia in cirrhotic patients with ascites

BMC Gastroenterology

Research Article

Chih-Chun Tsai¹  Kuo-Chih Tseng²  Tsung-Hsing Hung²  Yu-Hsi Hsieh²  Chih-Wei Tseng²  Chen-Chi Tsai³ 

[1] Department of Mathematics, Tamkang University, Tamsui, Taiwan;Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan;School of Medicine, Tzu Chi University, Hualien, Taiwan;School of Medicine, Tzu Chi University, Hualien, Taiwan;Division of Infectious disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan;

关键词: Cirrhosis;    Ascites;    Infections;    Pneumonia;    Spontaneous bacterial peritonitis;   

DOI  :  10.1186/1471-230X-13-25

 received in 2012-07-01, accepted in 2013-01-28,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundCirrhotic patients with ascites are prone to develop various infectious diseases. This study aimed to evaluate the occurrence and effect of major infectious diseases on the mortality of cirrhotic patients with ascites.MethodsWe reviewed de-identified patient data from the National Health Insurance Database, derived from the Taiwan National Health Insurance Program, to enroll 4,576 cirrhotic patients with ascites, who were discharged from Taiwan hospitals between January 1, 2004 and June 30, 2004. We collected patients’ demographic and clinical data, and reviewed diagnostic codes to determine infectious diseases and comorbid disorders of their hospitalizations. Patients were divided into an infection group and non-infection group and hazard ratios (HR) were determined for specific infectious diseases.ResultsOf the total 4,576 cirrhotic patients with ascites, 1,294 (28.2%) were diagnosed with infectious diseases during hospitalization. The major infectious diseases were spontaneous bacterial peritonitis (SBP) (645, 49.8%), urinary tract infection (151, 11.7%), and pneumonia (100, 7.7%). After adjusting for patients’ age, gender, and other comorbid disorders, the HRs of infectious diseases for 30-day and 90-day mortality of cirrhotic patients with ascites were 1.81 (1.54-2.11) and 1.60 (1.43-1.80) respectively, compared to those in the non-infection group. The adjusted HRs of pneumonia, urinary tract infection (UTI), spontaneous bacterial peritonitis (SBP), and sepsis without specific focus (SWSF) were 2.95 (2.05-4.25), 1.32 (0.86-2.05), 1.77 (1.45-2.17), and 2.19 (1.62-2.96) for 30-day mortality, and 2.57 (1.93-3.42), 1.36 (1.01-1.82), 1.51 (1.29-1.75), and 2.13 (1.70-2.66) for 90-day mortality, compared to those in the non-infection group.ConclusionInfectious diseases increased 30-day and 90-day mortality of cirrhotic patients with ascites. Among all infectious diseases identified, pneumonia carried the highest risk for mortality.

【 授权许可】

Unknown   
© Hung et al; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.