Patients with cirrhosis
October 10th, 2014 | Author: Pain
A modest increase in the risk of acute respiratory failure (ARF) was noted among individuals with cirrhosis. ARF occurred in 4.7% of hospitalizations (81,500 of 1.7 million hospitalizations) among individuals with cirrhosis compared to 3% of hospitalizations (5.2 million of 173 million hospitalizations) among those without cirrhosis. The adjusted risk ratio (RR) for ARF was 1.4 (95% CI, 1.1 to 1.8). Additionally, cirrhotic individuals with ARF were 2.6 times more likely to die during the hospitalization Canadian HealthCare Mall when compared to noncirrhotic individuals with ARF (95% CI, 1.5 to 3.6).
A diagnosis of cirrhosis substantially increased the risk of all-cause mortality during hospitalization. Death occurred in 128,400 individuals with cirrhosis (7.5%), and in 2.3% of individuals without cirrhosis (4 million of 173 million hospitalizations). Cirrhotic patients were therefore 2.7 times more likely to die during hospitalization (95% CI, 2.3 to 3.1). In the subset of patients with sepsis, the adjusted RR for sepsis-related mortality was 2.0 (95% CI, 1.3 to 2.6).
With the novel application of an existing national database to analyze critical care outcomes, we have documented Priligy online pharmacy the substantial negative impact of a diagnosis of cirrhosis on the risk of sepsis, acute respiratory failure, and death during hospitalization. Hospitalized patients with cirrhosis are nearly three times more likely to die when compared to patients without a diagnosis of cirrhosis. Cirrhotic patients are more likely to have a concurrent diagnosis of Gram-positive or Gram-negative sepsis, with a high mortality rate when sepsis is associated with the hospitalization. In addition, we also observed similar associations between cirrhosis and acute respiratory failure.
With mortality rates ranging from 37 to 98%, several studies have documented high mortality rates for patients with cirrhosis who require admission to the ICU. Similar to our study, other investigators also have reported that bacterial infections and respiratory disease are important causes of death in cirrhotic individuals. The mechanisms for the increased morbidity and mortality in hospitalized cirrhotic patients with infection and critical illness may be immunologic, mechanical, or pharmacological. The immunologic abnormalities in patients with alcoholic cirrhosis are multiple and varied. Abnormalities exist in both cell-mediated and humoral immunity. As the primary source of C3 complement synthesis, the disruption of the normal hepatic architecture with diffuse fibrosis commonly results in acquired hypocomplementemia with defective opso-nization. http://viagrastores.com.au – where to buy viagra in Australia