P4677 - Clinical Outcomes in Metabolic Dysfunction-Associated Fatty Liver Disease Patients Admitted With Acute Respiratory Failure

Fernando R. Mateo, MD¹, M Kenan Rahima, MD¹, Mhd Kutaiba Albuni, MD², Tochukwu Ikpeze, MD, MBA, MS³, Venkata Muddana, MD^4
1TriHealth Good Samaritan Hospital, Cincinnati, OH; ²TriHealth, Doha, Ad Dawhah, Qatar; ³TriHealth, CIncinatti, OH; ⁴TriHealth, Cincinnati, OH

Introduction: Acute Respiratory Failure (ARF) and Metabolic Dysfunction Associated Fatty Liver Disease (MAFLD) are characterized by systemic inflammation. Acute respiratory distress syndrome (ARDS), initiates a systemic inflammatory response affecting multiple organs. MAFLD is associated with low-grade systemic inflammation. There's limited evidence examining the outcomes of patients presenting with both ARF and MAFLD. Our objective was to assess clinical outcomes in this population.

Methods: We accessed the National Inpatient Sample from 2017-2020 to identify adults with MAFLD hospitalized with ARF. The primary endpoint was inpatient mortality, with secondary endpoints of cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), length of stay (LOS), and hospital charges. We utilized multivariable logistic regression analysis to estimate clinical outcomes, considering a threshold of P < 0.05.

Results: We identified 13,100,000 hospitalizations with ARF, 720,940 (5.5%) presented MAFLD. Comparing MAFLD and Non-MAFLD cohorts, mean age was 63 vs 67 years, males 55.2% vs 49.4%, and White ethnicity 65.3% vs 70%. The prevalence of obesity was 19.1% vs 22.4%, chronic obstructive pulmonary disease (COPD) 29% vs 44%, dyslipidemia 28.7% vs 41.1%, atrial fibrillation (AFIB) 27.1% vs 27.5%, hypertension 20% vs 27%, heart failure 43.1% vs 43.2%, peripheral vascular disease (PVD) 2.8% vs 3.7%, and chronic kidney disease (CKD) 31% vs 28%. Clinical outcomes between cohorts: in-hospital mortality rates were 37.6% vs 12.1% with an odds ratio (OR) of 4.77 (CI 4.69-4.84); Cardiogenic shock rate 13.6% vs 2.6% (OR 4.55, CI 4.44-4.66); Cardiac arrest rates 14.3% vs 3.96% with OR 3.46 (CI 3.38–3.54); Intensive care need 43.1% vs 18.6% with an OR of 2.7 (CI 2.68-2.77); GI bleeding 12.3% vs 4% (OR 2.94, CI 2.89-3.0); LOS 11.3 days vs 8.2 days (IRR 1.2, CI 1.19-1.22); and hospital charges were 47,847 vs 25,377 (IRR 1.56, CI 1.54-1.58). All data with a p-value < 0.001 and adjusted for various factors including age, sex, race, comorbidity indices, ARF, and inflation during 2017-2020.

Discussion: Patients hospitalized for ARF and MAFLD were younger, with fewer females and Caucasians. They exhibited less obesity, AFIB, COPD, or PVD. Importantly, they showed worse clinical outcomes, including higher mortality rates, adverse events (GIB, cardiac arrest, cardiogenic shock), prolonged LOS, and increased resource utilization. Clinicians should consider MAFLD as a negative predictor when managing patients with ARF.



Disclosures:


Fernando R. Mateo, MD¹, M Kenan Rahima, MD¹, Mhd Kutaiba Albuni, MD², Tochukwu Ikpeze, MD, MBA, MS³, Venkata Muddana, MD⁴. P4677 - Clinical Outcomes in Metabolic Dysfunction-Associated Fatty Liver Disease Patients Admitted With Acute Respiratory Failure, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.