Falls and malnutrition are associated with in-hospital mortality in patients with cirrhosis.

Autor:	Abedin N; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Hein M; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Queck A; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Mücke MM; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Weiler N; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Pathil A; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Mihm U; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Welsch C; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Bojunga J; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Zeuzem S; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany., Herrmann E; Goethe University Frankfurt, Institute of Biostatistics and Mathematical Modelling, Frankfurt am Main, Germany., Dultz G; Medical Clinic 1, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.
Jazyk:	angličtina
Zdroj:	Hepatology communications [Hepatol Commun] 2024 Sep 27; Vol. 8 (10). Date of Electronic Publication: 2024 Sep 27 (Print Publication: 2024).
DOI:	10.1097/HC9.0000000000000535
Abstrakt:	Background: Hospitalized patients with end-stage liver disease are at risk of malnutrition, reduced body function, and cognitive impairment due to HE. This combination may have an impact on in-hospital falls and mortality. The purpose of this study was to identify factors associated with the risk of falls and to analyze the consequences regarding in-hospital mortality. Methods: We performed a retrospective analysis of patients hospitalized with liver cirrhosis between 2017 and 2019 at the Department of Gastroenterology at the University Hospital Frankfurt. Clinical data, laboratory work, and follow-up data were analyzed. Factors associated with the risk of falls and in-hospital mortality were calculated using a mixed effect poisson regression model and competing risk time-to-event analyses. Results: Falls occurred with an incidence of 4% (80/1985), including 44 injurious falls with an incidence rate of 0.00005/100 patient-days (95% CI: 0.00001-0.00022). In the multivariate analysis malnutrition (incidence risk ratio: 1.77, 95% CI: 1.04-3.04) and implanted TIPS (incidence risk ratio: 20.09, 95% CI: 10.1-40.1) were independently associated with the risk of falling. In a total of 21/80 (26.25%) hospitalizations, patients with a documented fall died during their hospital stay versus 160/1905 (8.4%) deaths in hospitalizations without in-hospital fall. Multivariable analysis revealed as significant clinical predictors for in-hospital mortality a Nutritional Risk Screening ≥2 (HR 1.79, 95% CI: 1.32-2.4), a falling incident during hospitalization (HR 3.50, 95% CI: 2.04-6.0), high MELD, and admission for infections. Conclusions: Malnutrition and TIPS are associated with falls in hospitalized patients with liver cirrhosis. The in-hospital mortality rate of patients with cirrhosis with falls is high. Specific attention and measures to ameliorate these risks are warranted. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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