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Nonalcoholic fatty liver disease is associated with worse intestinal complications in patients hospitalized for Clostridioides difficile infection

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World Journal of Hepatology 2021年第11期13卷 1777-1790页

作者： Yi Jiang Salil Chowdhury Bing-Hong Xu Mohamad Aghaie Meybodi Konstantinos Damiris samanthika devalaraju Nikolaos Pyrsopoulos Department of Medicine Rutgers New Jersey Medical SchoolNewarkNJ 07101United States Liver Center and Center for Asian Health RWJBH-Saint Barnabas Medical CenterFlorham ParkNJ 07932United States Department of Medicine Gastroenterology and HepatologyRutgers New Jersey Medical SchoolNewarkNJ 07101United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)has become the leading cause of chronic liver disease with increasing prevalence *** difficile infection(CDI)remains the most common cause of nosocomial diarrhea in developed *** To assess the impact of NAFLD on the outcomes of hospitalized patients with *** This study was a retrospective cohort *** Nationwide Inpatient Sample database was used to identify a total of 7239 adults admitted as inpatients with a primary diagnosis of CDI and coexisting NAFLD diagnosis from 2010 to 2014 using ICD-9 *** with CDI and coexisting NAFLD were compared to those with CDI and coexisting alcoholic liver disease(ALD)and viral liver disease(VLD),*** outcomes included mortality,length of stay,and total hospitalization *** outcomes were in-hospital *** regression was used for outcome analysis after adjusting for possible *** CDI with NAFLD was independently associated with lower rates of acute respiratory failure(2.7%vs 4.2%,P<0.01;2.7%vs 4.2%,P<0.05),shorter length of stay(days)(5.75±0.16 vs 6.77±0.15,P<0.001;5.75±0.16 vs 6.84±0.23,P<0.001),and lower hospitalization charges(dollars)(38150.34±1757.01 vs 46326.72±1809.82,P<0.001;38150.34±1757.01 vs 44641.74±1660.66,P<0.001)when compared to CDI with VLD and CDI with ALD,*** with NAFLD was associated with a lower rate of acute kidney injury(13.0%vs 17.2%,P<0.01),but a higher rate of intestinal perforation(P<0.01)when compared to VLD.A lower rate of mortality(0.8%vs 2.7%,P<0.05)but a higher rate of intestinal obstruction(4.6%vs 2.2%,P=0.001)was also observed when comparing CDI with NAFLD to *** Hospitalized CDI patients with NAFLD had more intestinal complications compared to CDI patients with VLD and *** microbiota dysbiosis may contribute to the pathogenesis of intestinal complications.

关键词： Nonalcoholic fatty liver disease Clostridioides difficile infection Gut microbiota Intestinal complications Alcoholic liver disease Viral liver disease

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