Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;357(4):296-301.
doi: 10.1016/j.amjms.2019.01.004. Epub 2019 Jan 11.

Impact of Cirrhosis on Pneumonia-Related Outcomes in Hospitalized Older Veterans

Zachary Boivin  1 , Mario F Perez  1 , Nkiruka C Atuegwu  1 , Antonio Anzueto  2 , Eric M Mortensen  3
Affiliations

Impact of Cirrhosis on Pneumonia-Related Outcomes in Hospitalized Older Veterans

Zachary Boivin et al. Am J Med Sci. 2019 Apr.

Abstract

Background: Prior research has demonstrated high mortality rates in patients with cirrhosis who contract bacterial infections. The purpose of our study was to explore clinical outcomes such as 90-day mortality, rehospitalization, and intensive care unit (ICU) admission in older veterans with pneumonia and cirrhosis.

Methods: We conducted a retrospective cohort study of hospitalized patients with community-acquired pneumonia at any Departments of Veterans Affairs (VA) hospital over a 10-year period. We included patients 65 years or older who consistently received VA care and who were diagnosed with community-acquired pneumonia. There were 103,997 patients who met the inclusion criteria, and 1,246 patients with cirrhosis. We used multilevel regression models to examine the association between cirrhosis and the outcomes of interest after controlling for potential confounders.

Results: Cirrhosis was associated with significantly increased odds of 90-day mortality (odds ratio 1.79, 95% confidence interval, 1.57-2.04). There were also significantly increased odds of rehospitalization within 90-days (1.30, 1.16-1.47). No significant association was found with ICU admission (1.00, 0.83-1.19).

Conclusions: We found an association between cirrhosis and 90-day mortality and rehospitalization in older patients with pneumonia. We suggest that physicians should carefully monitor patients with cirrhosis who develop pneumonia.

Keywords: Cirrhosis; Mortality; Pneumonia; Rehospitalization.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: There are no conflicts of interest for any author.

Figures

Figure 1:
Figure 1:
Survival curves demonstrating a statistically significant (p<0.0001) increase in mortality in patients with a history of cirrhosis
See this image and copyright information in PMC

References

    1. Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: Final Data for 2014. Natl Vital Stat Rep. 2016;65(4):1–122. - PubMed
    1. Strauss E The impact of bacterial infections on survival of patients with decompensated cirrhosis. Annals of hepatology. 2013;13(1):7–19. - PubMed
    1. Christou L, Pappas G, Falagas ME. Bacterial infection-related morbidity and mortality in cirrhosis. Am J Gastroenterol. 2007;102. - PubMed
    1. Arvaniti V, D’Amico G, Fede G, et al. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology. 2010;139. - PubMed
    1. Hung TH, Hsieh YH, Tsai CC, Tseng KC, Tsai CC. Is liver cirrhosis a risk factor for osteonecrosis of the femoral head in adults? A population-based 3-year follow-up study. Intern Med. 2011;50. - PubMed

Publication types