Abstract
Chronic liver disease (CLD) associated with infections has a high short-term mortality. Infections are the first cause of mortality in CLD patients. The information of these patients in Mexico is limited. Identify the prevalence of infections in CLD patients in a hospital in Monterrey, Mexico. Data was obtained from one hospital (August 2017-October 2019). Patients ≥18 years old with CLD diagnosis by clinical, biochemical, imaging and/or histological criteria were included. Exclusion criteria were patients with incomplete information, antibiotic use <7 days before hospitalization, cancer, or use of immunosuppressant drugs. Data included demography, clinical presentation, diagnosis, prognostic scores (Child-Turcotte-Pugh -CTP- and the Model for End-Stage Liver Disease-Sodium -MELD-Na-), infections, and in-hospital mortality. Infectious Diseases Society of America (IDSA) criteria were used to define infections. Descriptive statistics, Chi squared test, Mann-Whitney U test, and Logistic regression were used to analyze data. 393 patients aged 55 years old (54.6±11.4) were included, 81% male patients. 79% were diagnosed with CLD in hospitalization. 55% were CTP Class C and 69% had a MELD-Na >17. 92 patients had an infection. 76% were community acquired. The main cause of infections was spontaneous bacterial peritonitis (30.4%). 212 cultures were obtained, but only 22 isolated a microorganism; 50% reported E. Coli, and 54% were multidrug-resistant bacteria. Mortality was 25%. Patients with infections had a higher mortality. Infections were related with a worst prognostic score: CTP class C (OR 3.78, CI 95% [1.10–12.93]; p=0.034); MELD-Na >17 (OR 2.07, CI 95% [1.16–3.68]; p=0.013). Infections had a higher risk of death (OR 4.38, CI 95% [2.41–6.75]; p<0.0001). Prevalence of infections in CLD patients is similar to other countries. These infections are associated with a worst CLD prognosis and have a four-fold risk of mortality.
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