The multifaceted spectrum of liver cirrhosis in older hospitalised patients: analysis of the REPOSI registry

Abstract Background Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main...

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Bibliographic Details
Published in:Age and ageing 2021-03, Vol.50 (2), p.498-504
Main Authors: De Vincentis, Antonio, Vespasiani-Gentilucci, Umberto, Costanzo, Luisa, Novella, Alessio, Cortesi, Laura, Nobili, Alessandro, Mannucci, Pier Mannuccio, Incalzi, Raffaele Antonelli
Format: Article
Language:English
Subjects:
Cirrhosis
Clinical outcomes
Disability
Intensive care
Liver
Liver cirrhosis
Medical prognosis
Mortality
Patients
Phenotypes
Sex ratio
Social interactions
Social support
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Summary:Abstract Background Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. Methods A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. Results LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age–sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10–1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37–3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P 
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/afaa150