Outcomes and factors associated with cryptococcal disease among cirrhotics : A study of the national inpatient sample 2005 to 2014

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BACKGROUND: Cryptococcal disease (CD) confers a higher mortality in cirrhotic patients compared to non-cirrhotic patients. Factor association for CD in cirrhotic patients is poorly understood. Our aim was to determine the incidence, demographic, and comorbidities associated with CD among cirrhotic patients in the United States (US).

METHOD: Retrospective analysis of admissions of cirrhotic patients, with or without CD, using the National Inpatient Sample (NIS) database from 2005 to 2014. The number of admissions were reported in raw and weighted frequencies. The trends of CD among cirrhotic patients and overall CD were evaluated. Rao-Scott chi-square, t-tests, and multivariate logistic regressions were performed to evaluate variables and CD among cirrhotic patients.

RESULTS: There were 886,962 admissions for cirrhosis, and 164 of these with CD. By adjusted odds ratio (AOR), CD was more often associated with cirrhosis in Southern (2.95; 95 % CI 1.24, 7.02) and Western regions (4.45; 95 % CI 1.91, 10.37), Hispanic patients (1.80; 95 % CI 1.01, 3.20), and patients with chronic kidney disease (CKD) (3.13; 95 % CI 2.09, 4.69). Of note, CD in cirrhotic patients was associated with higher inpatient mortality (AOR of 3.89, 95 % CI 2.53, 5.99), longer length of stay (9.87 vs. 4.88 days), and a higher total charge ($76,880 vs. $ 37,227) when compared to cirrhotic patients without CD.

DISCUSSION: Patients with cirrhosis admitted with CD have a high inpatient mortality. The geographical location and CKD were important factors associated with CD among cirrhotic patients. Autoimmune liver diseases and immunosuppression did not appear to increase the risk of CD.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:48

Enthalten in:

Clinics and research in hepatology and gastroenterology - 48(2024), 5 vom: 15. Mai, Seite 102337

Sprache:

Englisch

Beteiligte Personen:

Patel, Kishan [VerfasserIn]
Twohig, Patrick [VerfasserIn]
Peeraphatdit, Thoetchai [VerfasserIn]
Stohs, Erica J [VerfasserIn]
Samson, Kaeli [VerfasserIn]
Smith, Lynette [VerfasserIn]
Patel, Jay [VerfasserIn]
Manatsathit, Wuttiporn [VerfasserIn]

Links:

Volltext

Themen:

Cirrhosis
Cohort
Cryptococcus
Journal Article
Mortality
Outcomes

Anmerkungen:

Date Completed 04.05.2024

Date Revised 04.05.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.clinre.2024.102337

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370983629