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 23 May 2018

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News

Bacterial infections change natural history of cirrhosis 

Bacterial infections change natural history of cirrhosis irrespective of liver disease severity, reports this month's issue of the American Journal of Gastroenterology.

News image

Dr Emmanuel Tsochatzis and colleagues from the United Kingdom assessed the prognostic significance of infections in relation to current prognostic scores, and explored if infection could be considered per se a distinct clinical stage in the natural history of cirrhosis.

The researchers included consecutive patients with cirrhosis admitted to a tertiary referral liver unit for at least 48 hours over a 2-year period. 

Diagnosis of infection was based on positive cultures or strict established criteria. 

The research team used competing risk analysis and propensity score matching for data analysis.

The researchers reported that 501 patients underwent 781 admissions over the study period. 

The incidence of proven bacterial infection was 26%
American Journal of Gastroenterology
Portal hypertensive bleeding and complicated ascites were the commonest reasons of admission. 

The research team found that the incidence of proven bacterial infection was 26%.

Survival rates at 3, 6, 12, and 30 months were 83%, 77%, 71%, and 62% in patients without diagnosis of infection, vs. 50%, 46%, 41%, and 34% in patients with diagnosis of infection. 

The researchers found that the overall survival was independently associated with MELD score, intensive care stay, and bacterial infection. 

The team noted that bacterial infection was an independent predictor of survival even when patients who died within the first 30 days were excluded from the analysis.

Dr Tsochatzis' team comments, "Infection most likely represents a distinct prognostic stage of cirrhosis, which affects survival irrespective of disease severity, even after recovery from the infective episode."

Am J Gastroenterol 2017; 112:588–596
24 April 2017

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