Lai Chih-Cheng, Ho Chung-Han, Cheng Kuo-Chen, Chao Chien-Ming, Chen Chin-Ming, Chou Willy
Chih-Cheng Lai, Chien-Ming Chao, Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan 736, Taiwan.
World J Gastroenterol. 2017 Mar 28;23(12):2201-2208. doi: 10.3748/wjg.v23.i12.2201.
To assessed the effect of liver cirrhosis (LC) on the poorly understood long-term mortality risk after first-ever mechanical ventilation (1-MV) for acute respiratory failure.
All patients in Taiwan given a 1-MV between 1997 and 2013 were identified in Taiwan's Longitudinal Health Insurance Database 2000. Each patient with LC was individually matched, using a propensity-score method, to two patients without LC. The primary outcome was death after a 1-MV.
A total of 16653 patients were enrolled: 5551 LC-positive (LC) patients, including 1732 with cryptogenic LCs and 11102 LC-negative (LC) controls. LC patients had more organ failures and were more likely to be admitted to medical department than were LC controls. LC patients had a significantly lower survival rate (AHR = 1.38, 95%CI: 1.32-1.44). Moreover, the mortality risk was significantly higher for patients with non-cryptogenic LC than for patients with cryptogenic LC (AHR = 1.43, 95%CI: 1.32-1.54) and patients without LC (AHR = 1.56, 95%CI: 1.32-1.54). However, there was no significant difference between patients with cryptogenic and without LC (HR = 1.05, 95%CI: 0.98-1.12).
LC, especially non-cryptogenic LC, significantly increases the risk of death after a 1-MV.
评估肝硬化（LC）对首次因急性呼吸衰竭进行机械通气（1-MV）后尚未被充分了解的长期死亡风险的影响。
在台湾2000年纵向健康保险数据库中识别出1997年至2013年间接受1-MV的所有台湾患者。使用倾向评分法将每位LC患者与两名无LC的患者进行个体匹配。主要结局是1-MV后的死亡。
共纳入16653例患者：5551例LC阳性（LC）患者，包括1732例隐源性LC患者和11102例LC阴性（LC）对照。与LC对照相比，LC患者有更多器官功能衰竭，且更有可能入住内科。LC患者的生存率显著较低（风险比=1.38，95%置信区间：1.32-1.44）。此外，非隐源性LC患者的死亡风险显著高于隐源性LC患者（风险比=1.43，95%置信区间：1.32-1.54）和无LC患者（风险比=1.56，95%置信区间：1.32-1.54）。然而，隐源性LC患者和无LC患者之间无显著差异（风险比=1.05，95%置信区间：0.98-1.12）。
LC，尤其是非隐源性LC，显著增加1-MV后的死亡风险。
