Inpatient Cirrhosis Deaths on the Decline

Despite increases in liver cirrhosis hospitalizations over the years, the cirrhotic inpatient death rate has dropped 41%.

Researchers examined 781,515 hospitalized patients with cirrhosis between 2002 and 2010 and then compared their data with patients without cirrhosis and those with congestive heart failure (CHF).

In that time period, cirrhotic inpatient mortality rates dropped from 9.1% to 5.4%, while patients without cirrhosis saw a more modest decline in cirrhosis-related death rates, from 2.6% to 2.1%. Meanwhile, mortality rates among CHF patients fell from 2.5% in 2002 to 1.4% in 2010.

The researchers noted this decrease in cirrhotic inpatient deaths is especially significant considering the US population is growing older and patients are becoming more medically complex. Cirrhosis-related death rates dropped across all age brackets, even those aged older than 80 years.

“The improving inpatient survival despite aging and more medically complex cirrhotic patients is remarkably consistent across several cirrhosis complications and suggests improving cirrhosis care that may extend beyond general improvements in inpatient care,” the study authors concluded.

They pointed to a number of improvements in cirrhosis care since 2002, which may help explain the decrease in deaths.

“Increased awareness of disease management and earlier diagnosis for cirrhosis-related complications may have led to better survival rates,” said lead study author Monica Schmidt, MPH, research associate at the University of North Carolina Liver Center, in a press release.

Patients with cirrhosis have also seen shorter hospital stays, which decreased from an average of 6.95 days in 2002 to 5.88 days in 2010, according to the researchers.

Conditions associated with a higher mortality rate included sepsis, hepatorenal syndrome, hepatocellular carcinoma, variceal bleeding, and spontaneous bacterial peritonitis. The highest independent risk factor for death was sepsis, which had an increasing related mortality rate over the years. Considering cirrhotic patients with sepsis fare worse than those without cirrhosis, the researchers suggested cirrhotic patients may need a more “tailored approach” to treatment.