TY - JOUR
T1 - End-Stage Liver Disease in Patients with Intracranial Hemorrhage Is Associated with Increased Mortality
T2 - A Cohort Study
AU - Lagman, Carlito
AU - Nagasawa, Daniel T.
AU - Sheppard, John P.
AU - Jacky Chen, Cheng Hao
AU - Nguyen, Thien
AU - Prashant, Giyarpuram N.
AU - Niu, Tianyi
AU - Tucker, Alexander M.
AU - Kim, Won
AU - Pouratian, Nader
AU - Kaldas, Fady M.
AU - Busuttil, Ronald W.
AU - Yang, Isaac
N1 - Funding Information:
Conflict of interest statement: C. Lagman is supported by the Tina and Fred Segal Benign Brain Tumor and Skull Base Surgery Research Fellowship. J.P. Sheppard and T. Nguyen are supported by David Geffen Medical Scholarships. I. Yang is supported by the UCLA Visionary Ball Fund Grant, Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research UCLA Scholars in Translational Medicine Program Award, Jason Dessel Memorial Seed Grant, UCLA Honberger Endowment Brain Tumor Research Seed Grant, and Stop Cancer (US) Research Career Development Award.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/5
Y1 - 2018/5
N2 - Objective: To determine if end-stage liver disease (ESLD) in patients with intracranial hemorrhage (ICH) is associated with increased mortality. Methods: This single-center, retrospective cohort study included 53 patients (33 in ESLD cohort and 20 in non-ESLD cohort) who received neurosurgical care between 2006 and 2017. ESLD was defined clinically as severely impaired liver function and at least 1 major complication of liver failure. The primary outcome was mortality. Results: Overall, in-hospital, and 30-day mortality rates were higher in the ESLD cohort versus the non-ESLD cohort (79 vs. 30%, 79 vs. 20%, and 64 vs. 25%, all P ≤ 0.01). We identified a significant difference in overall survival between ESLD and non-ESLD cohorts on Kaplan-Meier analysis (P = 0.004 with log-rank and Wilcoxon tests). Odds of overall, in-hospital, and 30-day mortality in the ESLD cohort were 8.67 (95% confidence interval [CI], 2.44–30.84), 14.86 (95% CI, 3.75–58.90), and 5.25 (95% CI, 1.53–18.08). Other predictors of overall mortality included primary admission diagnosis of liver disease (odds ratio [OR] = 9.60; 95% CI, 3.75–58.90), higher Child-Pugh (OR = 1.64; 95% CI, 2.66–34.67) and Model for End-Stage Liver Disease (OR = 1.12; 95% CI, 1.04–1.20) scores, lower Glasgow Coma Scale score (OR = 0.73; 95% CI, 0.61–0.88), ICH that developed in the hospital (OR = 4.11; 95% CI, 1.21–13.98), and intraparenchymal hemorrhage (OR = 9.23; 95% CI, 1.72–49.56). Conclusions: ESLD in patients with ICH is associated with increased mortality.
AB - Objective: To determine if end-stage liver disease (ESLD) in patients with intracranial hemorrhage (ICH) is associated with increased mortality. Methods: This single-center, retrospective cohort study included 53 patients (33 in ESLD cohort and 20 in non-ESLD cohort) who received neurosurgical care between 2006 and 2017. ESLD was defined clinically as severely impaired liver function and at least 1 major complication of liver failure. The primary outcome was mortality. Results: Overall, in-hospital, and 30-day mortality rates were higher in the ESLD cohort versus the non-ESLD cohort (79 vs. 30%, 79 vs. 20%, and 64 vs. 25%, all P ≤ 0.01). We identified a significant difference in overall survival between ESLD and non-ESLD cohorts on Kaplan-Meier analysis (P = 0.004 with log-rank and Wilcoxon tests). Odds of overall, in-hospital, and 30-day mortality in the ESLD cohort were 8.67 (95% confidence interval [CI], 2.44–30.84), 14.86 (95% CI, 3.75–58.90), and 5.25 (95% CI, 1.53–18.08). Other predictors of overall mortality included primary admission diagnosis of liver disease (odds ratio [OR] = 9.60; 95% CI, 3.75–58.90), higher Child-Pugh (OR = 1.64; 95% CI, 2.66–34.67) and Model for End-Stage Liver Disease (OR = 1.12; 95% CI, 1.04–1.20) scores, lower Glasgow Coma Scale score (OR = 0.73; 95% CI, 0.61–0.88), ICH that developed in the hospital (OR = 4.11; 95% CI, 1.21–13.98), and intraparenchymal hemorrhage (OR = 9.23; 95% CI, 1.72–49.56). Conclusions: ESLD in patients with ICH is associated with increased mortality.
KW - Intracranial hemorrhages
KW - Liver diseases
KW - Mortality
KW - Neurosurgery
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U2 - 10.1016/j.wneu.2018.02.025
DO - 10.1016/j.wneu.2018.02.025
M3 - Article
C2 - 29452322
AN - SCOPUS:85044154665
SN - 1878-8750
VL - 113
SP - e320-e327
JO - World neurosurgery
JF - World neurosurgery
ER -