Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Republic of Korea.
Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do, Republic of Korea.
Medicine (Baltimore). 2023 Feb 22;102(8):e33074. doi: 10.1097/MD.0000000000033074.
Liver cirrhosis (LC) is a major cause of morbidity and mortality worldwide and is becoming a regional and healthcare burden. South Korea is one of the 10 countries with the highest age standardized prevalence of decompensated LC. Moreover, the proportion of patients with alcoholic LC is increasing and there has been no decrease in the incidence of decompensated alcoholic LC. Patients with decompensated LC frequently visit the emergency department (ED). Several studies focused on patients with LC who visited the ED, but the studies about alcoholic LC were limited. This study aimed to identify predicting factors for mortality in alcoholic LC patients visiting the ED. This was a retrospective study of alcoholic LC patients who visited an ED between November 2017 and June 2021. The baseline characteristics, complications of LC, model for end-stage liver disease (MELD) score, and laboratory values including lactate were assessed. The primary outcome was in-hospital mortality. In total, 433 patients with alcoholic LC were included for analysis and the in hospital mortality rate was 15.9% (n = 69). Univariate regression analyses identified that MELD score, lactate, platelet, international normalized ratio, bilirubin, creatinine, albumin, and C-reactive protein (CRP) predicted in-hospital mortality. Multivariate regression analysis showed that MELD score, lactate, albumin, and CRP were significantly associated with in-hospital mortality. MELD score, lactate, albumin, and CRP predicted the mortality in alcoholic LC patients visiting the ED.
肝硬化(LC)是全球发病率和死亡率的主要原因,并且正在成为一个地区性和医疗保健负担。韩国是 10 个年龄标准化失代偿性 LC 患病率最高的国家之一。此外,酒精性 LC 患者的比例正在增加,而且失代偿性酒精性 LC 的发病率并没有下降。失代偿性 LC 患者经常去急诊部(ED)就诊。有几项研究集中在去 ED 的 LC 患者,但关于酒精性 LC 的研究有限。本研究旨在确定去 ED 的酒精性 LC 患者死亡的预测因素。这是一项回顾性研究,纳入了 2017 年 11 月至 2021 年 6 月期间去 ED 的酒精性 LC 患者。评估了基线特征、LC 并发症、终末期肝病模型(MELD)评分以及包括乳酸在内的实验室值。主要结局是住院期间死亡率。共纳入 433 例酒精性 LC 患者进行分析,住院死亡率为 15.9%(n=69)。单因素回归分析确定 MELD 评分、乳酸、血小板、国际标准化比值、胆红素、肌酐、白蛋白和 C 反应蛋白(CRP)预测住院死亡率。多因素回归分析显示,MELD 评分、乳酸、白蛋白和 CRP 与住院死亡率显著相关。MELD 评分、乳酸、白蛋白和 CRP 预测了去 ED 的酒精性 LC 患者的死亡率。