title: Hospital mortality over time in patients with specific complications of cirrhosis.
abstract: Hospital mortality secondary to cirrhosis is high.
  
  
  OBJECTIVE
  To evaluate hospital mortality in patients admitted for specific complications of cirrhosis over time.
  
  
  METHODS
  Registry-data from Administrative Inpatient Dataset of acute care hospitals were collected at discharge from 2003 to 2010. Inclusion criteria were as follows: hospital admissions where one of the diagnoses was cirrhosis and the reason for admission was a specific complication of cirrhosis (ascites, encephalopathy, hepatorenal syndrome and haemorrhage from varices, bacterial spontaneous peritonitis). Analysis of variance was used for comparisons of quantitative variables and Chi-square for qualitative variables. Logistic regression was performed to identify the risk factors associated with hospital mortality; the Hosmer and Lemeshow test was applied to evaluate calibration and the ROC curve for discrimination respectively.
  
  
  RESULTS
  A total of 12,671 hospital admissions were analysed; 67.7% were men. Mean hospitalization stay was 10.9 (SD 9.2) days and the most frequent causes were encephalopathy (44.2%) and ascites (30.9%). Global hospital mortality was 11.6%. Logistic regression showed that once all factors had been adjusted, hepatorenal syndrome conveyed the highest risk for death (49.2%; OR = 8.1(95%CI:6.6-9.9). Risk of death was also increased by associated comorbidities and older age. Hospital mortality in the period 2006-2010 was 27% inferior to the period 2003-2005. The area under the ROC curve (AUROC) was 0.77 (95%CI 0.76-0.78).
  
  
  CONCLUSIONS
  Hospital mortality as a result of specific complications of cirrhosis is high, but has been declining in recent years.
authors.affiliation: Digestive Diseases Unit, Hospital de Sabadell, Universitat Autònoma de Barcelona, Sabadell, Spain. mvergara@tauli.cat
authors.forename: Mercedes
authors.initials: M
authors.lastname: Vergara
authors.forename: Montse
authors.initials: M
authors.lastname: Clèries
authors.forename: Emili
authors.initials: E
authors.lastname: Vela
authors.forename: Montserrat
authors.initials: M
authors.lastname: Bustins
authors.forename: Mireia
authors.initials: M
authors.lastname: Miquel
authors.forename: Rafael
authors.initials: R
authors.lastname: Campo
mesh_terms: D000368:Aged; D019540:Area Under Curve; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors