Which Factors are Predictive for Mortality among Hospitalized Patients with Cirrhosis?

BACKGROUND/AIMS: Cirrhotic patients admitted to the hospital have a high mortality rate. The aim of this study was to evaluate predictors of mortality in patients hospitalized for specific complications of cirrhosis. METHODOLOGY: All patients admitted to the gastroenterology service with cirrhosis during a 2-year period were retrospectively identified. We compared the clinical characteristics of patients who died and those who survived. Multivariable analysis was performed to determine predictors of mortality. RESULTS: A total of 84 patients were included in the study. In hospital mortality rate was 35%. Hepatorenal syndrome development (41% vs 4%, p < 0.001), MELD score (17 vs 12, p = 0.003), Child Pugh score (11 vs 8, p < 0.001), serum creatinine (p < 0.001) and serum potassium values (p = 0.01) were significantly higher in patients who died. Stepwise logistic regression analysis revealed that the best model in prediction of death included serum potassium levels (OR = 2.182; 95% Cl: 1.189-4.006; p < 0.001) and Child Pugh score (OR = 2.140; 95% CI: 1.507-3,038; p = 0.012). CONCLUSIONS: The mortality of cirrhotic patients admitted to hospital is significantly high. Prevention of acute kidney injury will be an appropriate approach for improving the survival in hospitalized patients with cirrhosis.

Evaluation of metabolic syndrome frequency and carotid artery intima-media thickness as risk factors for atherosclerosis in patients with nonalcoholic fatty liver disease.

AIM: The aim of this study was to evaluate metabolic syndrome (MetS) frequency and carotid artery intima-media thickness (IMT) as risk factors for atherosclerosis in patients with nonalcoholic fatty liver disease. METHODS: A case-control study was conducted on 40 biopsy-proven NAFLD patients and 40 age-matched healthy control subjects. Common carotid artery IMT and MetS criteria [according to the Third Report of the National Cholesterol Education Expert Panel on Detection, evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII), the International Diabetes Federation (IDF), the American Heart Association in conjunction with the National Heart, Lung, and Blood Institute (AHA/NHLBI)] were evaluated for all study subjects. RESULTS: MetS according to NCEP-ATPIII, IDF and AHA/NHLBI criteria was present in 55, 67.5 and 62.5% of NAFLD patients, respectively. The mean IMT was significantly higher in NAFLD patients (0.646 +/- 0.091 mm) than control subjects (0.544 +/- 0.067 mm), (P < 0.001). Among the vascular risk factors evaluated, the diagnosis of NAFLD and increased body mass index were significant independent predictors of increased IMT. CONCLUSIONS: As cardiovascular risk factors, both MetS and increased IMT occur frequently among NAFLD patients. Screening for both conditions might be beneficial for assessment of future atherosclerotic complications.