Factors predicting mortality in patients with alcoholic liver cirrhosis visiting the emergency department

Medicine (Baltimore). 2023 Feb 22;102(8):e33074. doi: 10.1097/MD.0000000000033074.

Abstract

Liver cirrhosis (LC) is a major cause of morbidity and mortality worldwide and is becoming a regional and healthcare burden. South Korea is one of the 10 countries with the highest age standardized prevalence of decompensated LC. Moreover, the proportion of patients with alcoholic LC is increasing and there has been no decrease in the incidence of decompensated alcoholic LC. Patients with decompensated LC frequently visit the emergency department (ED). Several studies focused on patients with LC who visited the ED, but the studies about alcoholic LC were limited. This study aimed to identify predicting factors for mortality in alcoholic LC patients visiting the ED. This was a retrospective study of alcoholic LC patients who visited an ED between November 2017 and June 2021. The baseline characteristics, complications of LC, model for end-stage liver disease (MELD) score, and laboratory values including lactate were assessed. The primary outcome was in-hospital mortality. In total, 433 patients with alcoholic LC were included for analysis and the in hospital mortality rate was 15.9% (n = 69). Univariate regression analyses identified that MELD score, lactate, platelet, international normalized ratio, bilirubin, creatinine, albumin, and C-reactive protein (CRP) predicted in-hospital mortality. Multivariate regression analysis showed that MELD score, lactate, albumin, and CRP were significantly associated with in-hospital mortality. MELD score, lactate, albumin, and CRP predicted the mortality in alcoholic LC patients visiting the ED.

MeSH terms

  • C-Reactive Protein
  • Emergency Service, Hospital
  • End Stage Liver Disease* / complications
  • Humans
  • Lactates
  • Liver Cirrhosis / complications
  • Liver Cirrhosis, Alcoholic* / complications
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • C-Reactive Protein
  • Lactates