Paracentesis Is Associated With Reduced Mortality in Patients Hospitalized With Cirrhosis and Ascites
Paracentesis Is Associated With Reduced Mortality in Patients Hospitalized With Cirrhosis and Ascites
复制标题
DOI：
10.1016/j.cgh.2013.08.025
复制
发表时间：
2014-03-01
影响因子：
12.6
通讯作者：
Barritt, A. Sidney
中科院分区：
文献类型：
--
作者：
Orman, Eric S.;Hayashi, Paul H.;Barritt, A. Sidney
背景与目的：诊断性穿刺术被推荐用于因腹水或脑病住院的肝硬化患者。然而，目前尚不清楚美国的临床医生是否坚持这一建议;穿刺和临床结果之间的关系尚未报道。我们分析了美国的数据库，以确定穿刺的频率及其与mortality.METHODS：2009年全国住院患者样本（其中包含每年约800万医院出院的数据）被用来识别肝硬化和腹水患者，这些患者被初步诊断为腹水或脑病。比较了接受和不接受穿刺术的患者的住院死亡率、住院时间和住院费用。结果进行了比较，为那些谁收到了早期穿刺术（入院后1天内）和那些谁收到一个later.RESULTS：17,711合格的入场，只有61%进行了穿刺术。接受穿刺术的患者的住院死亡率降低了24%（6.5% vs 8.5%;校正比值比，0.55; 95%置信区间，0.41-0.74）。大多数穿刺（66%）发生在
BACKGROUND & AIMS: Diagnostic paracentesis is recommended for patients with cirrhosis who are admitted to the hospital for ascites or encephalopathy. However, it is not known whether clinicians in the United States adhere to this recommendation; a relationship between paracentesis and clinical outcome has not been reported. We analyzed a U.S. database to determine the frequency of paracentesis and its association with mortality.METHODS: The 2009 Nationwide Inpatient Sample (which contains data from approximately 8 million hospital discharges each year) was used to identify patients with cirrhosis and ascites who were admitted with a primary diagnosis of ascites or encephalopathy. In-hospital mortality, length of stay, and hospital charges were compared for those who did and did not undergo paracentesis. Outcomes were compared for those who received an early paracentesis (within 1 day of admission) and those who received one later.RESULTS: Of 17,711 eligible admissions, only 61% underwent paracentesis. In-hospital mortality was reduced by 24% among patients who underwent paracentesis (6.5% vs 8.5%; adjusted odds ratio, 0.55; 95% confidence interval, 0.41-0.74). Most paracenteses (66%) occurred