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#Gastroenterology #Hepatology #Multispeciality
Mounting evidence suggest that usually the prognosis of critically ill patients with cirrhosis is poor. The authors of the present study evaluated the effect of different age groups (< 65 years, 65–74 years, and ≥ 75 years) on the short- and medium-term outcomes of cirrhotic patients in the intensive-care-unit (ICU) setting. This cohort study comprised of 226 consecutive patients with liver cirrhosis who were admitted to the ICU. A comparison was made between the different age groups to evaluate the clinical outcomes, including ICU mortality, in-hospital mortality, ventilator-free days, ICU days, ICU-free days, hospital days, and hospital-free days.
The results declared that the overall ICU mortality in patients aged < 65 years, 65–74 years, and ≥ 75 years was reported to be 29.4%, 20.0%, and 30.3%, respectively. However, variation of age no significant difference in mortality or clinical outcomes in patients with compensated cirrhosis. Moreover, age ≥ 75 years was significantly associated with in-hospital mortality, 6-month mortality, hospital days, and hospital-free days in patients with decompensated cirrhosis. Besides, this age had significant in-hospital mortality (hazard ratio: 2.61) and 6-month mortality (hazard ratio: 2.34), while adjusting for sex, coronary artery disease, etiology of ICU admission, Acute Physiology and Chronic Health Evaluation II score, Model for End-Stage Liver Disease score, and mechanical ventilation.
Thus, the study concluded that variation in old age, during ICU stay, does not influence ICU mortality, ventilator-free days, ICU days, or ICU-free days in cirrhotic patients (both compensated and decompensated cirrhosis). However, age ≥ 75 years becomes an independent prognostic factor for in-hospital mortality and 6-month mortality in patients with decompensated cirrhosis after ICU discharge.
Source: Cheng-Yi C, Chih-Jen W, Chi-Feng P, Han-Hsiang C, Yu-Wei C. Influence of Age on Critically Ill Patients with Cirrhosis. International Journal of Gerontology. 2015 Dec;9(4):233-238.