Introduction: Liver cirrhosis represents an advanced liver condition characterized by extensive fibrosis and nodular regeneration, arising from chronic liver inflammation, and is linked to significant morbidity and mortality through various complications. Acute ischemic stroke (AIS) manifests suddenly with neurological deficits due to arterial blockage or narrowing supplying blood to the brain, leading to ischemia and subsequent neuronal injury. The hospitalization outcomes influenced by the concurrent presence of liver cirrhosis in AIS patients are limited. This study aimed to assess the impact of liver cirrhosis on hospitalization outcomes in patients admitted with AIS.
Methods: A retrospective analysis of National Inpatient Sample (NIS) data spanning from 2016 to 2020 identified adult patients hospitalized with a primary diagnosis of AIS. Patients were stratified into groups based on a secondary diagnosis of liver cirrhosis. Hospital outcomes, including in-hospital mortality, length of stay (LOS), total hospital charges (THC), and complications, were compared between patients with and without liver cirrhosis. Linear and multivariate logistic regression models were adjusted for relevant covariates, with statistical significance set at p < 0.05.
Results: Among 3,338,804 hospitalized patients with acute ischemic stroke, 30,985 had liver cirrhosis. Patients with liver cirrhosis exhibited higher in-hospital mortality (13.84% vs. 6.66%; P < 0.001), longer length of stay (mean LOS 9.38 vs. 6.49 days; P < 0.001), and higher total hospital charges (USD 131,953.9 vs. 91,298.71; P < 0.001). After adjusting for confounding factors, patients with liver cirrhosis remained significantly associated with increased in-hospital mortality (adjusted odds ratio (aOR) = 1.56), sepsis (aOR = 1.68), septic shock (aOR = 1.94), acute kidney injury (aOR = 1.46), mechanical ventilator use (aOR = 1.14), and vasopressor use (aOR = 1.52), but had lower odds of thrombectomy (aOR = 0.64) and percutaneous endoscopic gastrostomy insertion (aOR = 0.65), all with P < 0.05.
Discussion: This study underscores the significant impact of liver cirrhosis on hospitalization outcomes in patients with acute ischemic stroke, highlighting elevated mortality rates, increased healthcare resource utilization, and adverse hospital outcomes. Further studies are warranted to explore additional factors impacting these outcomes, aiming to enhance understanding and refine management strategies for this complex patient population.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Natchaya Polpichai indicated no relevant financial relationships.
Sakditad Saowapa indicated no relevant financial relationships.
Emily Shu-Yen Chan indicated no relevant financial relationships.
Phuuwadith Wattanachayakul indicated no relevant financial relationships.
Thanathip Suenghataiphorn indicated no relevant financial relationships.
Noppachai Siranart indicated no relevant financial relationships.
Pojsakorn Danpanichkul indicated no relevant financial relationships.
Apichat Kaewdech indicated no relevant financial relationships.
Alirezaeza Borghei indicated no relevant financial relationships.
Natchaya Polpichai, MD1, Sakditad Saowapa, MD2, Emily Shu-Yen Chan, MD, MSc1, Phuuwadith Wattanachayakul, MD3, Thanathip Suenghataiphorn, MD4, Noppachai Siranart, MD5, Pojsakorn Danpanichkul, MD2, Apichat Kaewdech, MD6, Alirezaeza Borghei, MD1. P2918 - Unveiling the Impact of Liver Cirrhosis on Acute Ischemic Stroke Hospitalization: A Nationwide Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
