Table 2:
Comparison between patients in low/low middle, upper middle and high-income countries
| % (Freq) (Unless specified) | L/LMIC (n=714) | UMIC (n = 1757) | HIC (n = 1413) | P value | |||||
|---|---|---|---|---|---|---|---|---|---|
| Age (years) (Mean (Std)) | 48.51 (13.43) | 56.69 (12.80) | 58.58 (12.38) | <0.0001 | |||||
| Sex | <0.0001 | ||||||||
| Female | 171 (24%) | 638 (36%) | 582 (41%) | ||||||
| Diabetes | 178 (25%) | 472 (27%) | 498 (35%) | <0.0001 | |||||
| Cirrhosis etiology | |||||||||
| Hepatitis C | 39 (5%) | 156 (9%) | 186 (13%) | <0.0001 | |||||
| Alcohol | 315 (44%) | 463 (26%) | 811 (53%) | <0.0001 | |||||
| Non-alcoholic fatty liver disease | 126 (18%) | 169 (10%) | 391 (24%) | <0.0001 | |||||
| Hepatitis B | 129 (18%) | 608 (35%) | 68 (5%) | <0.0001 | |||||
| Cryptogenic | 65 (9%) | 178 (10%) | 55 (4%) | <0.0001 | |||||
| Others | 115 (16%) | 331 (19%) | 206 (15%) | 0.01 | |||||
| Cirrhosis history | |||||||||
| Prior LVP in 6M | 104 (15%) | 131 (7%) | 191 (14%) | <0.0001 | |||||
| Hospitalized in 6M | 283 (40%) | 845 (48%) | 817 (58%) | <0.0001 | |||||
| Prior HE in 6M | 187 (26%) | 377 (21%) | 492 (35%) | <0.0001 | |||||
| Variceal bleed in 6M | 249 (35%) | 523 (30%) | 337 (24%) | <0.0001 | |||||
| Transplant listed? | 52 (7%) | 178 (10%) | 162 (11%) | 0.01 | |||||
| Infected in the Past 6M | 122 (17%) | 298 (17%) | 348 (25%) | <0.0001 | |||||
| Prior HCC in 6M | 24 (3%) | 101 (6%) | 72 (5%) | 0.049 | |||||
| Prior hyponatremia | 118 (17%) | 219 (12%) | 331 (24%) | <0.0001 | |||||
| Prior ascites | 470 (66%) | 1038 (59.1%) | 980 (69%) | <0.0001 | |||||
| Admission Medications | |||||||||
| Betablockers | 269 (38%) | 466 (27%) | 467 (33%) | <0.0001 | |||||
| Lactulose | 448 (63%) | 517 (29%) | 662 (47%) | <0.0001 | |||||
| Rifaximin | 291 (41%) | 267 (15%) | 401 (28%) | <0.0001 | |||||
| Diuretics | 320 (45%) | 894 (51%) | 818 (58%) | <0.0001 | |||||
| Proton Pump Inhibitors | 367 (51%) | 513 (29%) | 782 (55%) | <0.0001 | |||||
| Statins | 26 (4%) | 82 (5%) | 273 (19%) | <0.0001 | |||||
| SBP Prophylaxis | 209 (29%) | 128 (7%) | 172 (12%) | <0.0001 | |||||
| HBV antivirals | 127 (18%) | 497 (28%) | 63 (4%) | <0.0001 | |||||
| Admission details | |||||||||
| Infection Admission | 188 (26%) | 362 (21%) | 275 (19%) | <0.0001 | |||||
| Liver Related Admission | 672 (94%) | 1653 (94.1%) | 1202 (85.1%) | <0.0001 | |||||
| MELD-Na (Median, IQR)) | 27 (20, 32) | 19 (13, 25) | 21 (16, 27) | <0.0001 | |||||
| Inpatient Outcomes | |||||||||
| Acute kidney injury development | 275 (42%) | 489 (28%) | 577 (42%) | <0.0001 | |||||
| Intensive care unit transfer | 252 (36%) | 180 (10%) | 290 (21%) | <0.0001 | |||||
| Grade 3–4 Hepatic encephalopathy | 130 (18%) | 183 (10%) | 171 (12%) | <0.0001 | |||||
| Ventilation | 109 (15%) | 120 (7%) | 150 (11%) | <0.0001 | |||||
| Vasopressor use | 129 (18%) | 183 (10%) | 133 (9%) | <0.0001 | |||||
| Nosocomial Infection | 108 (16%) | 181 (11%) | 165 (13%) | 0.007 | |||||
| LOS (Median, IQR)) | 8 (5, 12) | 10 (6, 17) | 8 (5, 16) | <0.0001 | |||||
| Inpatient mortality | 158 (22%) | 182 (10%) | 110 (8%) | <0.0001 | |||||
| Hospice transfer | 3 (0%) | 28 (2%) | 26 (2%) | <0.0001 | |||||
| Inpatient LT | 14 (2%) | 28 (2%) | 59 (4%) | <0.0001 | |||||
| Discharge MELD-Na (Median, IQR)) | 24 (13) | 17 (11) | 19 (11) | <0.0001 | |||||
| 30-day outcomes | |||||||||
| Lost to Follow-Up at 30 Days | 40 (6%) | 201 (11%) | 169 (12%) | <0.0001 | |||||
| Readmissions | 94 (18%) | 337 (25%) | 409 (36%) | <0.0001 | |||||
| Liver transplant | 16 (3%) | 57 (4%) | 110 (10%) | <0.0001 | |||||
| Mortality | 204 (30%) | 267 (17%) | 179 (14%) | <0.0001 |
P-values indicate differences between the three groups, HCV: hepatitis C virus, NAFLD: non-alcoholic fatty liver disease, HBV: hepatitis B virus, SBP: spontaneous bacterial peritonitis, LOS: length of stay, Std: standard deviation, MELD-Na: model for end-stage liver disease sodium, L/LMIC: low and lower middle income countries, UMIC: upper middle income countries, HIC: high income countries according to the World Bank classification.