Recent data suggest decreasing in-patient mortality in patients hospitalized with cirrhosis.
Dr Fasiha Kanwal and colleagues from Texas, USA determined if improvements in short-term outcomes for patients with cirrhosis are associated with changes in longer-term outcomes.
The research team examined temporal trends in 30 days and 1-year postdischarge mortality among patients hospitalized with cirrhosis at any of the 126 Veterans Administration hospitals from 2004 and 2013.
The team adjusted for a range of demographic, liver disease severity, and comorbidity-related factors to account for differences in patient cohorts over time.
|30-day mortality increased from 9% to 10%|
|American Journal of Gastroenterology|
The researchers identified 109,358 unique patients who were hospitalized with cirrhosis between 2004 and 2013.
In-hospital mortality decreased from 11% to 8%, whereas 1-year mortality decreased from 34% to 33%.
The team observed that over a third of out-of-hospital deaths occurred within the first 30 days after discharge.
The researchers noted that 30-day mortality increased from 9% to 10%.
After adjusting for patient factors, the odds of in-hospital mortality in 2013 were 30% lower, 1-year mortality were 13% lower, whereas the 30-day mortality were 10% higher than 2004, although the latter did not reach statistical significance.
Dr Kanwal's team concludes, "In patients admitted with cirrhosis, reduction in in-hospital mortality was associated with less marked reduction in 1-year mortality, and an unchanged, if not higher, 30-day mortality following discharge."
"Our data suggest that some of the burden of mortality in cirrhosis has shifted from in-hospital to the immediate postdischarge period."