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In-hospital cardiopulmonary resuscitation of patients with cirrhosis: A population-based analysis


Autoři: Lavi Oud aff001
Působiště autorů: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, United States of America aff001
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222873

Souhrn

Objective

To examine the epidemiology and outcomes of in-hospital cardiopulmonary resuscitation (CPR) among patients with cirrhosis.

Methods

We used the Texas Inpatient Public Use Data File to identify hospitalizations aged ≥ 18 years with and without cirrhosis during 2009–2014 and those in each group who have undergone in-hospital CPR. Short-term survival (defined as absence of hospital mortality or discharge to hospice) following in-hospital CPR was examined. Multivariate logistic regression modeling was used to assess the prognostic impact of cirrhosis following in-hospital CPR and predictors of short-term survival among cirrhosis hospitalizations.

Results

In-hospital CPR was reported in 2,511 and 51,969 hospitalizations with and without cirrhosis, respectively. The rate of in-hospital CPR (per 1,000 hospitalizations) was 7.6 and 4.0 among hospitalizations with and without cirrhosis, respectively. The corresponding rate of in-hospital CPR among decedents was 10.7% and 13.4%, respectively. Short-term survival following in-hospital CPR among hospitalizations with and without cirrhosis was 14.9% and 27.3%, respectively, and remained unchanged over time on adjusted analyses among the former (p = 0.1753), while increasing among the latter (p = 0.0404). Cirrhosis was associated with lower odds of short-term survival following in-hospital CPR (adjusted odds ratio [aOR] 0.55 [95% CI: 0.49–0.62]). Lack of health insurance (vs. Medicare) (aOR] 0.47 [95% CI: 0.34–0.67]) and sepsis ([aOR] 0.67 [95% CI: 0.53–85]) were associated with lower odds of short-term survival following in-hospital CPR among cirrhosis hospitalizations.

Conclusions

The rate of in-hospital CPR was nearly 2-fold higher among hospitalizations with cirrhosis than among those without it, though it was used more selectively among the former. Short-term survival following in-hospital CPR remained markedly lower among cirrhosis hospitalizations, while progressively improving among those without cirrhosis. Strategies to increase access to health insurance and improve early identification and control of infection should be explored in future preventive and interventional efforts.

Klíčová slova:

Resuscitation – Hospitals – Cirrhosis – Cerebrovascular diseases – Health insurance – Sepsis – Cardiac arrest


Zdroje

1. Scaglione S, Kliethermes S, Cao G, Shoham D, Durazo R, Luke A, Volk ML. The Epidemiology of Cirrhosis in the United States: A Population-based Study. J Clin Gastroenterol. 2015;49:690–696. doi: 10.1097/MCG.0000000000000208 25291348

2. Shaheen NJ, Hansen RA, Morgan DR, Gangarosa LM, Ringel Y, Thiny MT, Russo MW, Sandler RS. The burden of gastrointestinal and liver diseases. Am J Gastroenterol. 2006;101:2128–2138. doi: 10.1111/j.1572-0241.2006.00723.x 16848807

3. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States Part III: Liver, biliary tract, and pancreas. Gastroenterology. 2009;136:1134–1144. doi: 10.1053/j.gastro.2009.02.038 19245868

4. Schmidt ML, Barritt AS, Orman ES, Hayashi PH. Decreasing mortality among patients hospitalized with cirrhosis in the United States from 2002 through 2010. Gastroenterology. 2015;148:967–977. doi: 10.1053/j.gastro.2015.01.032 25623044

5. Majumdar A, Bailey M, Kemp WM, Bellomo R, Roberts SK, Pilcher D. Declining mortality in critically ill patients with cirrhosis in Australia and New Zealand between 2000 and 2015. J Hepatol. 2017;67:1185–1193. doi: 10.1016/j.jhep.2017.07.024 28802877

6. Stapleton RD, Ehlenbach WJ, Deyo RA, Curtis JR. Long-term outcomes after in-hospital CPR in older adults with chronic illness. Chest. 2014;146:1214–1225. doi: 10.1378/chest.13-2110 25086252

7. Ahmad S, Kumar N. Outcomes of cardiac arrest in cirrhosis. Gastroenterology. 2013; 144 (Suppl 1): Su1700.

8. Reinders ME, Wardi G, Bettencourt R, Bouland D, Bazick J, Mendler M, Vodkin I, Kalmaz D, Savides T, Brenner D, Sell RE, Loomba R. Increased Risk of Death, in the Hospital and Outside the Intensive Care Unit, for Patients With Cirrhosis After Cardiac Arrest. Clin Gastroenterol Hepatol. 2017;15:1808–1810. doi: 10.1016/j.cgh.2017.05.044 28602970

9. Kazaure HS, Roman SA, Sosa JA. Epidemiology and outcomes of in-hospital cardiopulmonary resuscitation in the United States, 2000–2009. Resuscitation. 2013;84:1255–1260. doi: 10.1016/j.resuscitation.2013.02.021 23470471

10. Mallikethi-Reddy S, Briasoulis A, Akintoye E, Jagadeesh K, Brook RD, Rubenfire M, Afonso L, Grines CL. Incidence and Survival After In-Hospital Cardiopulmonary Resuscitation in Nonelderly Adults: US Experience, 2007 to 2012. Circ Cardiovasc Qual Outcomes. 2017;10: e003194. doi: 10.1161/CIRCOUTCOMES.116.003194 28193738

11. Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz HM, Chan PS; American Heart Association Get with the Guidelines–Resuscitation Investigators. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012;367:1912–1920. doi: 10.1056/NEJMoa1109148 23150959

12. de Vos R, Koster RW, De Haan RJ, Oosting H, van der Wouw PA, Lampe-Schoenmaeckers AJ. In-hospital cardiopulmonary resuscitation: prearrest morbidity and outcome. Arch Intern Med. 1999;159:845–850. doi: 10.1001/archinte.159.8.845 10219930

13. Roedl K, Wallmüller C, Drolz A, Horvatits T, Rutter K, Spiel A, Ortbauer J, Stratil P, Hubner P, Weiser C, Motaabbed JK, Jarczak D, Herkner H, Sterz F, Fuhrmann V. Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis. Ann Intensive Care. 2017;7:103. doi: 10.1186/s13613-017-0322-1 28986855

14. Texas inpatient public use data file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. Available from: http://www.dshs.state.tx.us/thcic/hospitals/Inpatientpudf.shtm.

15. Oud L, Watkins P. Contemporary trends of the epidemiology, clinical characteristics, and resource utilization of necrotizing fasciitis in Texas: a population-based cohort study. Crit Care Res Pract. 2015;2015:618067. doi: 10.1155/2015/618067 25893115

16. Singal AK, Salameh H, Kamath PS. Prevalence and in-hospital mortality trends of infections among patients with cirrhosis: a nationwide study of hospitalised patients in the United States. Aliment Pharmacol Ther. 2014;40:105–112. doi: 10.1111/apt.12797 24832591

17. Kramer JR, Davila JA, Miller ED, Richardson P, Giordano TP, El-Serag HB. The validity of viral hepatitis and chronic liver disease diagnoses in Veterans Affairs administrative databases. Aliment Pharmacol Ther. 2008;27:274–282. doi: 10.1111/j.1365-2036.2007.03572.x 17996017

18. Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, Januel JM, Sundararajan V. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173:676–682. doi: 10.1093/aje/kwq433 21330339

19. Shahreyar M, Dang G, Waqas Bashir M, Kumar G, Hussain J, Ahmad S, Pandey B, Thakur A, Bhandari S, Thandra K, Sra J, Tajik AJ, Jahangir A. Outcomes of In-Hospital Cardiopulmonary Resuscitation in Morbidly Obese Patients. JACC Clin Electrophysiol. 2017;3:174–183. doi: 10.1016/j.jacep.2016.08.011 29759391

20. Hennessy S, Leonard CE, Freeman CP, Deo R, Newcomb C, Kimmel SE, Strom BL, Bilker WB. Validation of diagnostic codes for outpatient-originating sudden cardiac death and ventricular arrhythmia in Medicaid and Medicare claims data. Pharmacoepidemiol Drug Saf. 2010;19:555–562. doi: 10.1002/pds.1869 19844945

21. Chung CP, Murray KT, Stein CM, Hall K, Ray WA. A computer case definition for sudden cardiac death. Pharmacoepidemiol Drug Saf. 2010;19:563–572. doi: 10.1002/pds.1888 20029823

22. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003; 348: 1546–1554. doi: 10.1056/NEJMoa022139 12700374

23. Armitage P, Berry G, Matthews JNS. Statistical methods in medical research. 4th ed. Blackwell Science, 2002.

24. Lyon SM, Benson NM, Cooke CR, Iwashyna TJ, Ratcliffe SJ, Kahn JM. The effect of insurance status on mortality and procedural use in critically ill patients. Am J Respir Crit Care Med. 2011;184:809–815. doi: 10.1164/rccm.201101-0089OC 21700910

25. Zoch TW, Desbiens NA, DeStefano F, Stueland DT, Layde PM. Short- and long-term survival after cardiopulmonary resuscitation. Arch Intern Med. 2000;160:1969–1973. doi: 10.1001/archinte.160.13.1969 10888971

26. Khera R, Spertus JA, Starks MA, Tang Y, Bradley SM, Girotra S, Chan PS. Administrative Codes for Capturing In-Hospital Cardiac Arrest. JAMA Cardiol. 2017;2:1275–1277. doi: 10.1001/jamacardio.2017.2904 28877294


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2019 Číslo 9
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