Outcomes and Factors Associated with Cryptococcal Disease Among Cirrhotics: A Study of the National Inpatient Sample 2005 to 2014.

Cryptococcus cirrhosis cohort mortality outcomes

Journal

Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659

Informations de publication

Date de publication:
10 Apr 2024
Historique:
received: 28 12 2023
revised: 29 03 2024
accepted: 05 04 2024
medline: 13 4 2024
pubmed: 13 4 2024
entrez: 12 4 2024
Statut: aheadofprint

Résumé

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). Retrospective analysis of admissions of cirrhotic patients, with or without CD, using the National Inpatient Sample (NIS) database from 2005-2014. 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. There were 886,962 admissions for cirrhosis and 164 of these with CD with weighted frequency of 788.62. 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. 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.

Sections du résumé

BACKGROUND 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 METHODS
Retrospective analysis of admissions of cirrhotic patients, with or without CD, using the National Inpatient Sample (NIS) database from 2005-2014. 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 RESULTS
There were 886,962 admissions for cirrhosis and 164 of these with CD with weighted frequency of 788.62. 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 CONCLUSIONS
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.

Identifiants

DOI: 10.1016/j.clinre.2024.102337 PMID: 38609048
pubmed: 38609048
pii: S2210-7401(24)00058-5
doi: 10.1016/j.clinre.2024.102337
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102337

Informations de copyright

Copyright © 2024. Published by Elsevier Masson SAS.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Kishan Patel (K)

Division of Gastroenterology and Nutrition, Loyola University Medical Center, Maywood IL, USA, 60153.

Patrick Twohig (P)

Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha NE, USA, 68198.

Thoetchai Bee Peeraphatdit (TB)

Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha NE, USA, 68198.

Erica J Stohs (EJ)

Division of Infectious Diseases, University of Nebraska Medical Center, Omaha NE, USA, 68198.

Kaeli Samson (K)

Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha NE, USA, 68198.

Lynette Smith (L)

Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha NE, USA, 68198.

Jay Patel (J)

Department of Internal Medicine, University of Connecticut Medical Center, Farmington, CA, USA, 06030.

Wuttiporn Manatsathit (W)

Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha NE, USA, 68198. Electronic address: shane.manatsathit@unmc.edu.

Classifications MeSH