營養不良對住院肝硬化患者感染結局的影響：2011-2017年醫院

StephenW

The effect of malnutrition on the infectious outcomes of hospitalized patients with cirrhosis: analysis of the 2011–2017 hospital data

Lee, David Uihwan; Fan, Greg Hongyuan; Ahern, Ryan Richard; Karagozian, RaffiAuthor Information
European Journal of Gastroenterology & Hepatology: February 2021 - Volume 32 - Issue 2 - p 269-278
doi: 10.1097/MEG.0000000000001991

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Abstract
Background

In patients with cirrhosis, there is a clinical concern that the development of protein-calorie malnutrition will affect the immune system and predispose these patients to increased infectious outcomes.
Aims

In this study, we evaluate the effects of malnutrition on the infectious outcomes of patients admitted with cirrhosis.
Materials and methods

This study used the 2011–2017 National Inpatient Sample to identify patients with cirrhosis. These patients were stratified using malnutrition (protein-calorie malnutrition, cachexia, and sarcopenia) and matched using age, gender, and race with 1:1 nearest neighbor matching method. The endpoints included mortality and infectious outcomes.
Results

After matching, there were 96 842 malnutrition-present cohort and equal number of controls. In univariate analysis, the malnutrition cohort had higher hospital mortality [10.40 vs. 5.04% P < 0.01, odds ratio (OR) 2.18, 95% confidence interval (CI) 2.11–2.26]. In multivariate models, malnutrition was associated with increased mortality [P < 0.01, adjusted odds ratio (aOR) 1.32, 95% CI 1.27–1.37] and infectious outcomes, including sepsis (P < 0.01, aOR 1.94, 95% CI 1.89–2.00), pneumonia (P < 0.01, aOR 1.68, 95% CI 1.63–1.73), UTI (P < 0.01, aOR 1.39, 95% CI 1.35–1.43), cellulitis (P < 0.01, aOR 1.09, 95% CI 1.05–1.13), cholangitis (P < 0.01, aOR 1.39, 95% CI 1.26–1.55), and clostridium difficile (P < 0.01, aOR 2.11, 95% CI 1.92–2.31).
Conclusion

The results of this study indicate that malnutrition is an independent risk factor of hospital mortality and local/systemic infections in patients admitted with cirrhosis.
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

StephenW

营养不良对住院肝硬化患者感染结局的影响：2011-2017年医院数据分析

李·戴维wan（Lee）范格雷格宏远； Ahern，Ryan Richard；拉各斯Karagozian作者信息
欧洲胃肠病学和肝病学杂志：2021年2月-第32卷-第2期-第269-278页
doi：10.1097 / MEG.0000000000001991

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抽象
背景

在肝硬化患者中，临床上担心蛋白质卡路里营养不良的发展会影响免疫系统，并使这些患者容易感染。
目的

在这项研究中，我们评估了营养不良对肝硬化患者感染结局的影响。
材料和方法

本研究使用2011–2017年全国住院患者样本来鉴定肝硬化患者。使用营养不良（蛋白质热量营养不良，恶病质和肌肉减少症）对这些患者进行分层，并使用年龄，性别和种族与1：1最近邻匹配方法进行匹配。终点包括死亡率和感染性结果。
结果

匹配后，有96 842名存在营养不良的队列和相同数量的对照。在单因素分析中，营养不良人群的住院死亡率更高[10.40比5.04％P <0.01，优势比（OR）2.18，95％置信区间（CI）2.11–2.26]。在多变量模型中，营养不良与死亡率增加[P <0.01，校正比值比（aOR）1.32，95％CI 1.27-1.37]和包括败血症在内的传染性结局相关（P <0.01，aOR 1.94，95％CI 1.89-2.00 ），肺炎（P <0.01，aOR 1.68，95％CI 1.63–1.73），UTI（P <0.01，aOR 1.39，95％CI 1.35-1.43），蜂窝组织炎（P <0.01，aOR 1.09，95％CI 1.05– 1.13），胆管炎（P <0.01，aOR 1.39，95％CI 1.26–1.55）和艰难梭菌（P <0.01，aOR 2.11，95％CI 1.92–2.31）。
结论

这项研究的结果表明，营养不良是肝硬化患者住院死亡率和局部/全身感染的独立危险因素。
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