Infections Exert Heavy Mortality Toll in Cirrhosis

Infections increase mortality nearly four-fold; can be seen as additional prognostic factor in cirrhosis
By Eric Metcalf
HealthDay Reporter

FRIDAY, Oct. 22 (HealthDay News) -- In patients with cirrhosis, infections are associated with a steep increase in one-year mortality risk, according to research published in the October issue of Gastroenterology.

Vasiliki Arvaniti, of the Royal Free Hospital and University College London, and colleagues analyzed data from 178 studies that included 11,987 patients with cirrhosis.

The researchers found that the overall median mortality for patients with infections was 38 percent. At one month, mortality was 30.3 percent, and at one year it was 63 percent. The pooled odds ratio for death among infected patients compared to those without infections was 3.75. The median mortality in studies reporting spontaneous bacterial peritonitis was 43.7 percent, and in studies reporting bacteremia, median mortality was 42.2 percent.

"In conclusion, the mortality rate after infection in cirrhosis remains high and has not changed much over recent decades, particularly at one year after infection. To improve outcomes, new studies of prevention, similar to the one by Fernandez et al, are needed. In addition, earlier diagnosis is needed, whether by surrogates or new microbiologic techniques, to allow earlier treatment," the authors write. "New therapies require testing and individual types of infection need to be studied prospectively."

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