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- Title
Outcomes and risk factors for mortality in clostridioides difficile infection in patients with NAFLD and NASH.
- Authors
Patel, Ankoor H.; Pathak, Gaurav N.; Chen, Alexander; Greenberg, Patricia; Mazzaferro, Natale; Patel, Anish; Mallangada, Naveen; Minacapelli, Carlos D.; Catalano, Kaitlyn; Suthar, Hansel; Rustgi, Vinod K.
- Abstract
Introduction and Objectives: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide and can progress to non-alcoholic steatohepatitis (NASH) and, ultimately, cirrhosis. Clostridioides difficile is the most common nosocomial cause of diarrhea and is associated with worse clinical outcomes in other liver diseases, including cirrhosis, but has not been extensively evaluated in concomitant NAFLD/NASH. Materials and Methods: We conducted a retrospective cohort study using the National Inpatient Sample database from 2015 to 2017. Patients with a diagnosis of CDI, NAFLD, and NASH were identified using International Classification of Diseases (Tenth Revision) codes. The outcomes of our study include length of stay, hospitalization cost, mortality, and predictors of mortality. Results: The CDI and NASH cohort had a higher degree of comorbidity burden and prevalence of peptic ulcer disease, congestive heart failure, diabetes mellitus, and cirrhosis. Patients with NASH and CDI had a significantly higher mortality rate compared to the CDI only cohort (mortality, 7.11 % vs. 6.36 %; P = 0.042). Patients with CDI and NASH were at increased risk for liver-related complications, acute kidney injury, and septic shock (P < 0.001) compared to patients with CDI only. Older age, intestinal complications, pneumonia, sepsis and septic shock, and liver failure conferred an increased risk of mortality among the CDI and NASH cohort. Conclusions: Patients with NASH had a higher rate of liver-related complications, progression to septic shock, and mortality rate following CDI infection compared to the CDI only cohort.
- Subjects
CLOSTRIDIOIDES difficile; MORTALITY risk factors; NOSOLOGY; NON-alcoholic fatty liver disease; LIVER failure
- Publication
Annals of Hepatology: Official Journal of the Mexican Association of Hepatology, 2024, Vol 29, Issue 4, p1
- ISSN
1665-2681
- Publication type
Article
- DOI
10.1016/j.aohep.2024.101510