An analysis of clinical characteristic and related risk factors in 208 cirrhotic patients complicated with infections / 中华内科杂志

ABSTRACT

Objective To analyze the clinical features and risk factors of cirrhotic patients complicated with infections. Methods The clinical and laboratory characteristics of cirrhotic patients complicated with infections hospitalized from April 2014 to June 2017 were retrospectively analyzed. Relevant risk factors for infection and mortality were explored. Results The overall incidence of infections was 17.6％ in 1670 hospitalized cirrhotic patients. Among the recruited 208 patients in this study, alcoholic, viral hepatitis B or C and autoimmune liver diseases accounted for 29.8％ (62/208), 26.0％ (54/208), and 22.1％ (46/208), respectively. The most common infection site was respiratory tract (70.2％ ), followed by urinary tract, intestinal and intra-abdomen. Forty-six pathogens were isolated from 32 patients, including 22 (47.8％ ) Gram negative bacteria, 16 (34.8％ ) Gram positive bacteria and 2(4.3％ ) mycobacterium tuberculosis, 5 (10.9％) fungi and 1 (2.2％) mycoplasma. The mortality in patients with nosocomial infections (16.7％,7/42) was higher than that in patients with community-acquired infections (6.0％,10/166, P=0.025). All 17 deaths occurred in decompensated cirrhosis. Multivariate analysis demonstrated that hepatic encephalopathy and prothrombin time were independent risk factors of mortality. Conclusions Patients with decompensated cirrhosis are more susceptible to infections. Hepatic encephalopathy and prothrombin time are independent risk factors for death.