Impact of liver cirrhosis on ST-elevation myocardial infarction related shock and interventional management,a nationwide analysis  

作　　者：Sophia Haroon Dar Mehek Rahim Davood K Hosseini Khurram Sarfraz 

机构地区：[1]Internal Medicine,Hackensack University Medical Center,Hackensack,NJ 07601,United States

出　　处：《World Journal of Hepatology》2022年第4期766-777,共12页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Critical care is rapidly evolving with significant innovations to decrease hospital stays and costs.To our knowledge,there is limited data on factors that affect the length of stay and hospital charges in cirrhotic patients who present with STelevation myocardial infarction-related cardiogenic shock(SRCS).AIM To identify the factors that increase inpatient mortality,length of stay,and total hospital charges in patients with liver cirrhosis(LC)compared to those without LC.METHODS This study includes all adults over 18 from the National Inpatient Sample 2017 database.The study consists of two groups of patients,including SRCS with LC and without LC.Inpatient mortality,length of stay,and total hospital charges are the primary outcomes between the two groups.We used STATA 16 to perform statistical analysis.The Pearson's chi-square test compares the categorical variables.Propensity-matched scoring with univariate and multivariate logistic regression generated the odds ratios for inpatient mortality,length of stay,and resource utilization.RESULTS This study includes a total of 35798453 weighted hospitalized patients from the 2017 National Inpatient Sample.The two groups are SRCS without LC(n=758809)and SRCS with LC(n=11920).The majority of patients were Caucasian in both groups(67%vs 72%).The mean number of patients insured with Medicare was lower in the LC group(60%vs 56%)compared to the other group,and those who had at least three or more comorbidities(53%vs 90%)were significantly higher in the LC group compared to the non-LC group.Inpatient mortality was also considerably higher in the LC group(28.7%vs 10.63%).Length of Stay(LOS)is longer in the LC group compared to the non-LC group(9 vs 5.6).Similarly,total hospital charges are higher in patients with LC($147407.80 vs$113069.10,P≤0.05).Inpatient mortality is lower in the early percutaneous coronary intervention(PCI)group(OR:0.79<0.11),however,it is not statistically significant.Both early Impella(OR:1.73<0.05)and early extracorporeal membrane oxygenati

关 键 词：Gastroenterology HEPATOLOGY Liver ST-elevation myocardial infarction Cardiogenic Shock Percutaneous coronary intervention IMPELLA Extracorporeal membrane oxygenation 

分 类 号：R575.2[医药卫生—消化系统] R542.22[医药卫生—内科学]