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In-hospital mortality of hepatorenal syndrome in the United States:Nationwide inpatient sample

World Journal of Gastroenterology 2021年第45期27卷 7831-7843页

作者： Wisit Kaewput Charat Thongprayoon Carissa Y Dumancas Swetha R Kanduri Karthik Kovvuru Chalermrat Kaewput Pattharawin Pattharanitima tananchai petnak Ploypin Lertjitbanjong Boonphiphop Boonpheng Karn Wijarnpreecha Jose L Zabala Genovez Saraschandra Vallabhajosyula Caroline C Jadlowiec Fawad Qureshi Wisit Cheungpasitporn Department of Military and Community Medicine Phramongkutklao College of MedicineBangkok 10400Thailand Division of Nephrology and Hypertension Mayo ClinicRochesterMN 55905United States Division of Nephrology Department of MedicineOchsner Clinic FoundationNew OrleansLA 70121United States Division of Nuclear Medicine Department of RadiologyFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10400Thailand Department of Internal Medicine Faculty of MedicineThammasat UniversityPathum Thani 12121Thailand Division of Pulmonary and Pulmonary Critical Care Medicine Faculty of MedicineRamathibodi HospitalMahidol UniversityBangkok 10400Thailand Division of Pulmonary Critical Careand Sleep MedicineUniversity of Tennessee Health Science CenterMemphisTN 13326United States Division of Nephrology University of WashingtonSeattleWA 98195United States Division of Gastroenterology and Hepatology University of MichiganAnn ArborMI 48109United States Section of Cardiovascular Medicine Department of MedicineWake Forest University School of MedicineWinston-SalemNC 27101United States Division of Transplant Surgery Mayo ClinicPhoenixAZ 85054United States Division of Nephrology and Hypertension Department of MedicineMayo ClinicRochesterMN 55905United States

BACKGROUND Hepatorenal syndrome(HRS)is a life-threatening condition among patients with advanced liver *** trends specific to hospital mortality and hospital admission resource utilization for HRS remain *** To assess the temporal trend in mortality and identify the predictors for mortality among hospital admissions for HRS in the United *** We used the National Inpatient Sample database to identify an unweighted sample of 4938 hospital admissions for HRS from 2005 to 2014(weighted sample of 23973 admissions).The primary outcomes were temporal trends in mortality as well as predictors for hospital *** estimated odds ratios from multilevel mixed effect logistic regression to identify patient characteristics and treatments associated with hospital *** Overall hospital mortality was 32%.Hospital mortality decreased from 44%in 2005 to 24%in 2014(P<0.001),while there was an increase in the rate of liver transplantation(P=0.02),renal replacement therapy(P<0.001),length of hospital stay(P<0.001),and hospitalization cost(P<0.001).On multivariable analysis,older age,alcohol use,coagulopathy,neurological disorder,and need for mechanical ventilation predicted higher hospital mortality,whereas liver transplantation,transjugular intrahepatic portosystemic shunt,and abdominal paracentesis were associated with lower hospital *** Although there was an increase in resource utilizations,hospital mortality among patients admitted for HRS significantly *** predictors for hospital mortality were identified.

关键词： Hepatorenal syndrome Liver transplantation Mortality Nationwide Big data Hospitalization Outcomes Predictors

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