Inpatient Outcomes of Cirrhosis-related Cachexia in the United States

Abstract

Background and AimsCachexia is a metabolic syndrome defined by a loss of more than 5% of body weight in patients with chronic diseases. The goal of this study was to investigate the link between cirrhotic cachexia and hospital mortality and the 30-day risk of all-cause readmission. MethodsThe study utilized Nationwide Readmission Database for the years 2016-2019 in which all patients older than 18 years old with a primary diagnosis of cirrhosis were included. We excluded patients with a concurrent diagnosis of Human Immunodeficiency Virus (HIV), chronic lung disease, end-stage renal disease, malignancy, heart failure, and certain neurological diseases. We compared baseline characteristics and outcomes between those who were cachectic and those who were not. Survey multivariate logistic regression was used to analyze the independent impact of cachexia on categorical outcomes. ResultsThe study cohort was 342,030 cases. Cachexia was identified in approximately 17% of the study population (58,509 discharges). The mean age was 56 years. Slightly more female patients noted in cachexia group (41% vs. 38%). Inpatient mortality during index hospitalization were higher in patients with cirrhotic cachexia (6.7% versus 3%, p<0.01). Inpatient mortality during first all-cause readmission within 30 days of index discharge was also higher in cachexia group (8.6% versus 6.5%, p<0.01). ConclusionsCachexia is an adverse prognosticator for inpatient outcomes in patients with cirrhosis. It is associated with greater readmission rates, inpatient mortality, and prolonged hospital admissions.