Evidence map›Paper›PMID 34511813›Full record

ArticleJournal of clinical and experimental hepatology

The Clinical Impact of Cirrhosis on the Hospital Outcomes of Patients Admitted With Influenza Infection: Propensity Score Matched Analysis of 2011-2017 US Hospital Data.

David U Lee, Gregory H Fan, David J Hastie, Vibhav N Prakasam, Elyse A Addonizio, Ryan R Ahern, Kristen J Seog, Raffi Karagozian

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Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David U LeeLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Gregory H FanLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
David J HastieLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Vibhav N PrakasamLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Elyse A AddonizioLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Ryan R AhernLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Kristen J SeogLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Raffi KaragozianLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesPatients with cirrhosis have liver-related immune dysfunction that potentially predisposes the patients to increased influenza infection risk. Our study evaluates this cross-sectional relationship using a national registry of hospital patients.

methodsThis study included the 2011-2017 National Inpatient Sample database. From this, respiratory influenza cases were isolated and stratified using the presence of cirrhosis into a cirrhosis-present study cohort and cirrhosis-absent controls; propensity score matching method was used to match the controls to the study cohort (cirrhosis-present) using a 1:1 matching ratio. The endpoints included mortality, length of stay, hospitalization costs, and influenza-related complications.

resultsFollowing the match, there were 2,040 with cirrhosis and matched 2,040 without cirrhosis admitted with respiratory influenza infection. Compared to the controls, cirrhosis patients had higher in-hospital mortality (7.79 vs 3.43% p < 0.001, OR 2.38 95% CI 1.78-3.17), longer length of stay (7.25 vs 6.52 d p < 0.001), higher hospitalization costs ($70,009 vs $65,035 p < 0.001), and were more likely be discharged to a skilled nursing facility and home healthcare (vs routine home discharges). In terms of influenza-related complications, the cirrhosis cohort had higher rates of sepsis (29.8 vs 22% p < 0.001, OR 1.51 95% CI 1.31-1.74). In the multivariate regression analysis, cirrhosis was associated with higher mortality (p < 0.001, aOR 2.31 95% CI 1.59-3.35) and length of stay (p = 0.018, aOR 1.03 95% CI 1.01-1.06). In subgroup analysis of patients with decompensated (n = 597) versus compensated cirrhosis (n = 1443), those with decompensated cirrhosis had higher rates of in-hospital mortality (12.7 vs 5.75% p < 0.001, OR 2.39 95% CI 1.72-3.32), length of stay (8.85 vs 6.59 d p < 0.001), and hospitalization costs ($92,858 vs $60,556 p < 0.001). In the multivariate analysis, decompensated cirrhosis was associated with increased mortality (p < 0.001, aOR 2.86 95% CI 1.90-4.32).

conclusionThis study shows the presence of cirrhosis to result in higher hospital mortality and postinfluenza complications in patients with influenza infection.

Indexed as

AHRQ, agency for healthcare research and qualityascitescommon coldDRG, diagnosis-related groupfluHCUP, healthcare cost and utilization projectICD-10, international classification of diseases, tenth editionICD-9, international classification of diseases, ninth editioninfluenza-related complicationsNIS, nationwide inpatient sampleportal hypertensionSBP, spontaneous bacterial peritonitisSID, state inpatient databaseVIF, variation inflation factor

Identifiers

PMID34511813
PMCPMC8414330

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.