Lyu Xiuhong, Liu Bolun, Li Yiting, Wang Yichen, Miskovsky John, Gaitanis Melissa, Promrat Kittichai, Wu Wen-Chih
Department of Epidemiology, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, USA.
Department of Adult Medicine, Brockton Neighborhood Health Center, 63 Main Street, Brockton, MA 02301, USA.
J Clin Med. 2024 Sep 26;13(19):5737. doi: 10.3390/jcm13195737.
Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) are reported to have an increased risk of developing severe infections, leading to hospitalizations with sepsis. However, data regarding the impact of comorbid NAFLD on in-hospital outcomes of patients with sepsis is scarce. This nationwide retrospective observational study using discharge data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), and Agency for Healthcare Research and Quality included 21,057,911 adult patients who were admitted to hospitals in the United States between 2000 and 2019 with a primary discharge diagnosis of sepsis. These patients were categorized according to the presence or absence of comorbid NAFLD. The twenty-year trend of nationwide NAFLD prevalence among sepsis inpatients was elucidated. Multivariable logistic regression analysis was used to analyze NAFLD's impact on sepsis outcomes. : In the twenty-year study period, the prevalence of NALFD among sepsis inpatients trended up from 1.2% in 2000 to 4.2% in 2019. Similar trends were observed in regional analysis. While overall sepsis mortality decreased, comorbid NAFLD in sepsis patients was consistently associated with a higher adjusted in-hospital all-cause mortality rate (adjusted odds ratio (OR), 1.19; 95% confidence interval (CI), 1.07-1.32), higher odds of developing septic shock, and higher likelihood of development of multi-organ dysfunction. : Comorbid NAFLD in the stage of NASH or cirrhosis is associated with higher in-hospital all-cause mortality and worse clinical outcomes in sepsis inpatients. Addressing this rising epidemic will be of paramount importance to improve sepsis in-hospital outcomes.
据报道，非酒精性脂肪性肝病（NAFLD）患者发生严重感染的风险增加，导致因脓毒症住院。然而，关于合并NAFLD对脓毒症患者住院结局影响的数据却很少。这项全国性回顾性观察研究使用了来自国家住院样本（NIS）、医疗成本与利用项目（HCUP）以及医疗保健研究与质量局的出院数据，纳入了2000年至2019年期间在美国医院住院且主要出院诊断为脓毒症的21057911名成年患者。这些患者根据是否合并NAFLD进行分类。阐明了脓毒症住院患者中全国NAFLD患病率的二十年趋势。采用多变量逻辑回归分析来分析NAFLD对脓毒症结局的影响。：在二十年的研究期间，脓毒症住院患者中NALFD的患病率从2000年的1.2%上升至2019年的4.2%。在区域分析中也观察到了类似趋势。虽然总体脓毒症死亡率有所下降，但脓毒症患者合并NAFLD始终与更高的调整后住院全因死亡率（调整后的优势比（OR）为1.19；95%置信区间（CI）为1.07 - 1.32）、发生感染性休克的更高几率以及发生多器官功能障碍的更高可能性相关。：NASH或肝硬化阶段合并NAFLD与脓毒症住院患者更高的住院全因死亡率和更差的临床结局相关。应对这一不断上升的流行病对于改善脓毒症住院结局至关重要。
