Table 1.
Hospitalized ACLF cohort characteristics, stratified by inpatient specialty palliative care consultation status.
| Factor | No SPC consultation (n = 15,264) | SPC consultation (n = 6,723) | p value∗ |
|---|---|---|---|
| Age, median (interquartile range [IQR]) | 62.4 (57.2, 67.7) | 62.8 (57.7, 68.6) | <0.001 |
| Male sex | 14,907 (97.7%) | 6,558 (97.5%) | 0.60 |
| Race | <0.001 | ||
| White | 8,514 (55.8%) | 3,753 (55.8%) | |
| Black | 3,443 (22.6%) | 1,316 (19.6%) | |
| Hispanic | 1,297 (8.5%) | 678 (10.1%) | |
| Asian | 208 (1.4%) | 69 (1.0%) | |
| Other | 1,802 (11.8%) | 907 (13.5%) | |
| BMI, median (IQR) | 29.1 (25.4, 33.8) | 28.2 (24.5, 32.5) | <0.001 |
| Etiology of liver disease | <0.001 | ||
| Hepatitis C | 1,960 (12.8%) | 820 (12.2%) | |
| Hepatitis B | 132 (0.9%) | 51 (0.8%) | |
| Alcohol-associated liver disease | 5,952 (39.0%) | 2,791 (41.5%) | |
| HCV+ALD | 3,761 (24.6%) | 1,653 (24.6%) | |
| Non-alcoholic fatty liver disease | 3,158 (20.7%) | 1,256 (18.7%) | |
| Other | 301 (2.0%) | 152 (2.3%) | |
| CIRCOM score | <0.001 | ||
| Low | 3,693 (24.2%) | 2,555 (38.0%) | |
| High | 11,571 (75.8%) | 4,168 (62.0%) | |
| Diabetes mellitus | 11,021 (72.2%) | 4,197 (62.4%) | <0.001 |
| Coronary artery disease | 5,967 (39.1%) | 2,124 (31.6%) | <0.001 |
| Heart failure | 5,503 (36.1%) | 1,887 (28.1%) | <0.001 |
| Atrial fibrillation | 3,298 (21.6%) | 1,257 (18.7%) | <0.001 |
| Hepatocellular carcinoma | 1,372 (9.0%) | 1,390 (20.7%) | <0.001 |
| Prior history of decompensated cirrhosis | 9,051 (59.3%) | 4,405 (65.5%) | <0.001 |
| TIPS | 588 (3.9%) | 175 (2.6%) | <0.001 |
| Prior PC consultation | 1,524 (10.0%) | 1,568 (23.3%) | <0.001 |
| Sodium, median (IQR) | 134 (131–137) | 133 (128–136) | <0.001 |
| Creatinine, median (IQR) | 2.2 (1.6–3.2) | 2.06 (1.4–3.005) | <0.001 |
| AST, median (IQR) | 48 (29–88) | 69 (38–132) | <0.001 |
| ALT, median (IQR) | 30 (19–49) | 36 (22–63) | <0.001 |
| Albumin, median (IQR) | 2.6 (2.1–3.1) | 2.4 (2–2.8) | <0.001 |
| Total bilirubin, median (IQR) | 1.6 (0.8–3.6) | 3 (1.31–7.6) | <0.001 |
| INR, median (IQR) | 1.5 (1.2–2.06) | 1.7 (1.39–2.3) | <0.001 |
| PLT count, median (IQR) | 114 (73–170) | 105 (66–162) | <0.001 |
| WBC count, median (IQR) | 7.74 (5.36–11.5) | 9 (6.1–13.4) | <0.001 |
| MELD, median (IQR) | 22 (18–27) | 24 (19–30) | <0.001 |
| MELD-Na, median (IQR) | 24 (20–29) | 27 (22–32) | <0.001 |
| Max temp, median (IQR) | 98.4 (97.9–98.9) | 98.2 (97.8–98.8) | <0.001 |
| Min temp, median (IQR) | 97.4 (96.9–98) | 97.3 (96.8–97.8) | <0.001 |
| Max HR, median (IQR) | 88 (78–96) | 91 (81–97) | <0.001 |
| Max RR, median (IQR) | 20 (18–21) | 20 (18–22) | <0.001 |
| Academic-affiliated hospital | 9,993 (65.5%) | 4226 (62.9%) | <0.001 |
| Distance to transplant center (miles), median (IQR) | 3.4 (0.6–24.5) | 3.5 (0.7–39.4) | <0.001 |
| Rural hospital | 604 (4.0%) | 235 (3.5%) | 0.09 |
ACLF, acute-on-chronic liver failure; ALD, alcohol-associated liver disease; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CIRCOM, cirrhosis comorbidity score; HR, heart rate; INR, international normalized ratio; MELD(-Na), model for end-stage liver disease(-sodium); PC, palliative care; RR, respiratory rate; SPC, specialty palliative care; TIPS, transjugular intrahepatic portosystemic shunt; WBC, white blood cell.
∗
Wilcoxon rank-sum and Chi-square tests were used to determine statistically significant differences; level of significance: p = 0.001.