Alabbas Mohammad, Chaar Abdelkader, Gibson Cheryl A, Mohamad Alahmad Mohamad Alhoda
Interal Medicine Department A, University of Debrecen, Debrecen, Hungary.
Yale School of Medicine, Internal Medicine, New Haven, Connecticut.
Gastro Hep Adv. 2023 Dec 7;3(3):410-416. doi: 10.1016/j.gastha.2023.11.017. eCollection 2024.
Cachexia is a metabolic syndrome defined by a loss of more than 5% of body weight in patients with chronic diseases. The goal of this study was to investigate the link between cirrhotic cachexia and hospital mortality and the 30-day risk of all-cause readmission.
The study utilized Nationwide Readmission Database for the years 2016-2019 in which all patients older than 18 year old with a primary diagnosis of cirrhosis were included. We excluded patients with a concurrent diagnosis of Human Immunodeficiency Virus, chronic lung disease, end-stage renal disease, malignancy, heart failure, and certain neurological diseases. We compared baseline characteristics and outcomes between those who were cachectic and those who were not. Survey multivariate logistic regression was used to analyze the independent impact of cachexia on categorical outcomes.
The study cohort was 342,030 cases. Cachexia was identified in approximately 17% of the study population (58,509 discharges). The mean age was 56 years. Slightly more female patients noted in cachexia group (41% vs 38%). Inpatient mortality during index hospitalization were higher in patients with cirrhotic cachexia (6.7% vs 3%, < .01). Inpatient mortality during first all-cause readmission within 30 days of index discharge was also higher in cachexia group (8.6% vs 6.5%, < .01).
Cachexia is an adverse prognosticator for inpatient outcomes in patients with cirrhosis. It is associated with greater readmission rates, inpatient mortality, and prolonged hospital admissions.
恶病质是一种代谢综合征，定义为慢性病患者体重减轻超过5%。本研究的目的是调查肝硬化恶病质与医院死亡率以及30天全因再入院风险之间的联系。
该研究利用了2016 - 2019年的全国再入院数据库，纳入了所有年龄大于18岁且原发性诊断为肝硬化的患者。我们排除了同时诊断为人类免疫缺陷病毒、慢性肺病、终末期肾病、恶性肿瘤、心力衰竭和某些神经系统疾病的患者。我们比较了恶病质患者和非恶病质患者的基线特征和结局。采用多因素logistic回归分析恶病质对分类结局的独立影响。
研究队列共342,030例。在大约17%的研究人群（58,509例出院病例）中发现了恶病质。平均年龄为56岁。恶病质组女性患者略多（41%对38%）。肝硬化恶病质患者在首次住院期间的住院死亡率更高（6.7%对3%，P <.01）。恶病质组在首次出院后30天内首次全因再入院期间的住院死亡率也更高（8.6%对6.5%，P <.01）。
恶病质是肝硬化患者住院结局的不良预后因素。它与更高的再入院率、住院死亡率和更长的住院时间相关。
