Prior assessments of critical care outcomes in patients with cirrhosis have shown conflicting results. We aimed to provide nationwide generalizable results of critical care outcomes in patients with decompensated cirrhosis. This is a retrospective study using the National Inpatient Sample from 2016 to 2019. Adults with cirrhosis who required respiratory intubation, central venous catheter placement or both (n = 12,945) with principal diagnoses including: esophageal variceal hemorrhage (EVH, 24%), hepatic encephalopathy (58%), hepatorenal syndrome (HRS, 14%) or spontaneous bacterial peritonitis (4%) were included. A comparison cohort of patients without cirrhosis requiring intubation or central line placement for any principal diagnosis was included. Those with cirrhosis were younger (mean 58 vs. 63 years, p < 0.001) and more likely to be male (62% vs. 54%, p < 0.001). In-hospital mortality was higher in the cirrhosis cohort (33.1% vs. 26.6%, p < 0.001) and ranged from 26.7% in EVH to 50.6% HRS. Mortality when renal replacement therapy was utilized (n = 1580, 12.2%) was 46.5% in the cirrhosis cohort, compared to 32.3% in other hospitalizations (p < 0.001), and was lowest in EVH (25.7%) and highest in HRS (51.5%). Mortality when cardiopulmonary resuscitation was used was increased in the cirrhosis cohort (88.0% vs. 72.1%, p < 0.001) and highest in HRS (95.7%). One-third of patients with cirrhosis requiring critical care did not survive to discharge in this U.S. nationwide assessment. While outcomes were worse than in patients without cirrhosis, the results do suggest better outcomes compared to previous studies.

中文翻译：

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失代偿性肝硬化的重症监护结果：美国全国住院患者样本横断面研究

先前对肝硬化患者重症监护结果的评估显示出相互矛盾的结果。我们的目标是提供全国范围内失代偿性肝硬化患者重症监护结果的普遍结果。这是一项使用 2016 年至 2019 年全国住院患者样本的回顾性研究。需要呼吸插管、中心静脉导管置入或两者同时进行的肝硬化成人 (n = 12,945)，主要诊断包括：食管静脉曲张出血 (EVH，24%)、肝硬化包括脑病（58%）、肝肾综合征（HRS，14%）或自发性细菌性腹膜炎（4%）。纳入了一个比较队列，其中没有肝硬化的患者需要插管或中心静脉置管以进行任何主要诊断。肝硬化患者更年轻（平均 58 岁 vs. 63 岁，p < 0.001），并且更有可能是男性（62% vs. 54%，p < 0.001）。肝硬化队列的院内死亡率较高（33.1% vs. 26.6%，p < 0.001），范围从 EVH 的 26.7% 到 HRS 的 50.6%。肝硬化队列中采用肾脏替代治疗时的死亡率（n = 1580，12.2%）为 46.5%，而其他住院治疗的死亡率为 32.3%（p < 0.001），EVH 中死亡率最低（25.7%），HRS 中死亡率最高（ 51.5%）。肝硬化队列中使用心肺复苏时的死亡率增加（88.0% vs. 72.1%，p < 0.001），HRS 中死亡率最高（95.7%）。在这项美国全国评估中，三分之一需要重症监护的肝硬化患者未能存活出院。虽然结果比没有肝硬化的患者更差，但结果确实表明与之前的研究相比有更好的结果。