Table 1.
Demographic and Clinical Characteristics of 516 Patients With Liver Cirrhosis Admitted to the Hospital for Acute Decompensation
| No BFI | BFI at Admission | BFI During Hospitalization | P | |
|---|---|---|---|---|
| No. | 347 | 108 | 61 | |
| Anthropometric data | ||||
| Age, y | 61 (51–72) | 64 (53–74) | 61 (52–72) | .473 |
| Male sex | 209 (60) | 68 (63) | 43 (70) | .306 |
| Etiology of cirrhosis | ||||
| Virala | 142 (41) | 52 (48) | 26 (43) | .415 |
| Alcohol | 66 (19) | 21 (20) | 14 (23) | .775 |
| NASH | 17 (5) | 8 (7) | 4 (6) | .579 |
| Mixed etiologyb | 65 (19) | 11 (10) | 8 (13) | .085 |
| Other | 57 (16) | 16 (15) | 9 (15) | .893 |
| Main clinical features at admission | ||||
| Ascites | 192 (55) | 59 (55) | 39 (64) | .428 |
| HE grades III/IV | 62 (18) | 13 (12) | 8 (13) | .283 |
| Renal dysfunctionc | 61 (18) | 24 (22) | 23 (38)* | .002 |
| GI bleeding | 28 (8) | 2 (2) | 6 (10) | .056 |
| ACLF | 67 (19) | 21 (19) | 18 (30) | .182 |
| Grade 1 | 29 (43) | 12 (57) | 5 (28) | .182 |
| Grade 2 | 35 (52) | 6 (29) | 12 (67) | .050 |
| Grade 3 | 3 (5) | 3 (14) | 1 (6) | .282 |
| Renal failure | 31 (46) | 9 (43) | 13 (72) | .113 |
| Liver failure | 19 (28) | 6 (29) | 7 (39) | .677 |
| Coagulation failure | 12 (18) | 5 (24) | 1 (6) | .301 |
| Brain failure | 25 (37) | 7 (33) | 4 (22) | .485 |
| Respiratory failure | 0 (0) | 0 (0) | 5 (28) | <.001 |
| Circulatory failure | 0 (0) | 0 (0) | 0 (0) | 1.000 |
| Biochemical and hemodynamic data | ||||
| WBC, 109/L | 5.2 (3.5–7.4) | 7.8 (5.0–10.9)** | 5.6 (3.6–9.2) | <.001 |
| CRP, mg/dL | 0.93 (0.34–1.76) | 3.94 (1.69–8.15)** | 2.76 (0.62–5.46)** | <.001 |
| Platelets, 109/L | 90 (55–139) | 96 (61–176) | 74 (56–123) | .194 |
| Sodium, mmol/L | 137 (134–140) | 136 (133–138)* | 135 (132–139)* | <.001 |
| Bilirubin, mg/dL | 2.1 (1.1–4.3) | 2.4 (1.1–4.4) | 2.8 (1.5–10.3)* | .018 |
| Creatinine, mg/dL | 0.89 (0.73–1.30) | 1.03 (0.78–1.45) | 1.25 (0.88–1.85)** | <.001 |
| Albumin, mg/dL | 3.2 (2.8–3.6) | 3.0 (2.7–3.4) | 3.1 (2.8–3.5) | .080 |
| INR | 1.40 (1.23–1.56) | 1.39 (1.25–1.67) | 1.46 (1.28–1.73) | .077 |
| MAP, mmHg | 85 (80–93) | 83 (77–97) | 82 (75–90) | .105 |
| HR, bpm | 75 (65–84) | 80 (70–90)* | 80 (70–88)* | <.001 |
| Prognostic scores | ||||
| Child-Pugh score | 8 (7–10) | 8 (7–10) | 9 (8–11)** | .028 |
| Child-Pugh Class | ||||
| Class A | 83 (24) | 25 (23) | 7 (12) | .096 |
| Class B | 160 (46) | 55 (51) | 30 (49) | .655 |
| Class C | 104 (30) | 28 (26) | 24 (39) | .186 |
| MELD | 15 (11–20) | 16 (11–20) | 21 (14–27)** | .001 |
| MELD-Na | 16 (12–22) | 18 (14–24)** | 21 (17–30)** | <.001 |
| CLIF-C-AD | 50 (45–57) | 55 (50–63)* | 54 (49–59)* | <.001 |
| Concomitant medications | ||||
| PPI | 223 (64) | 74 (69) | 43 (71) | .518 |
| Beta-blockers | 150 (43) | 47 (44) | 26 (43) | .994 |
| Rifaximin | 104 (30) | 28 (26) | 20 (34) | .579 |
| Quinolones | 7 (2) | 1 (1) | 1 (2) | .748 |
| Transfer to ICU | 27 (8) | 8 (7) | 8 (13) | .352 |
| Comorbidities | ||||
| CCI | 6.0 (5.0–7.4) | 6.0 (4.8–7.4) | 6.2 (4.4–7.4) | .922 |
| HCC | 76 (22) | 33 (31) | 17 (28) | .156 |
| Diabetes (any stage) | 122 (35) | 39 (36) | 19 (31) | .795 |
Patients were divided according to the presence or lack of a BFI at the time of admission or the development of a hospital-acquired BFI.
*P < .05 vs no BFI; **P < .05 vs all.
Abbreviations: ACLF, acute-on-chronic liver failure; BFI, bacterial or fungal infection; CCI, Charlson comorbidity index; CLIF-C, Chronic Liver Failure Consortium; CRP, C-reactive protein; GI, gastrointestinal; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HE, hepatic encephalopathy; HR, heart rate; ICU, intensive care unit; INR, international normalized ratio; MAP, mean arterial pressure; MELD, Model for End-stage Liver Disease; NASH, non-alcoholic steatohepatitis; PPI, proton pump inhibitor; WBC, white blood cell count.
aViral etiology includes 152 HCV infection, 15 HBV infection, and 53 HBV/HCV coinfection.
bMixed etiology includes viral and alcohol, viral and metabolic, and alcohol and metabolic etiologies.
cRenal dysfunction was defined as serum creatinine level >1.5 mg/dL.