In patients with cirrhosis, infections represent a frequent trigger for complications, increasing frequency of hospitalizations and mortality rate.
Dr Paolo Angeli and colleagues identified predictors of early readmission, and of mid-term mortality in patients with liver cirrhosis discharged after a hospitalization for bacterial and/or fungal infection.
A total of 199 patients with cirrhosis discharged after an admission for a bacterial and/or fungal infection were included in the study and followed up for a least 6 months.
During follow-up, the team found that 35% were readmitted within 30 days from discharge.
|35% were readmitted within 30 days from discharge|
|American Journal of Gastroenterology|
C-reactive protein (CRP) value at discharge, diagnosis of acute-on-chronic liver failure during the hospital stay, and the hospitalization in the last 30 days previous to the admission/inclusion in the study were found to be independent predictors of readmission.
During the 6-month follow-up, the team observed that 23% of patients died.
Age, model of end-stage liver disease (MELD) score, CRP, refractory ascites, and diabetes were found to be independent predictors of 6-month mortality.
The researchers found that patients with a CRP >10 mg/l at discharge had a significantly higher probability of being readmitted within 30 days, and a significantly lower probability of 6-month survival than those with a CRP ≤10 mg/l.
Dr Angeli's team comments, "CRP showed to be a strong predictor of early hospital readmission and 6-month mortality in patients with cirrhosis after hospitalization for bacterial and/or fungal infection."
"CRP values could be used both in the stewardship of antibiotic treatment and to identify fragile patients who deserve a strict surveillance program."