Introduction: Cirrhosis cardiomyopathy is characterized by impaired contractile responsiveness to stress, impaired diastolic relaxation and electrophysiological abnormalities that developed in the setting of liver cirrhosis. Although hepatic-cardio disorder is an a widely studied disease, there was limited study that focus on the impact of alcoholic liver cirrhosis in in-hospital cardiac arrest. We examined the outcome of cardiopulmonary resuscitation (CPR) among patient with alcoholic liver cirrhosis.
Methods: The National Inpatient Sample 2018 database was used. We defined in-hospital cardiac arrest (IHCA) ICD-10-PCS code for cardiopulmonary resuscitation. Alcoholic liver cirrhosis was identified using ICD-10-CM codes (K70.30, K70.31). Comorbidities, ventricular tachycardia and ventricular fibrillation were identified by appropriate ICD-10-CM codes. Patient with chronic liver disease other than alcoholic liver cirrhosis was excluded. Statistical analysis was done using JMP15. We utilized multivariate logistic regression to analyze the risk of in-hospital mortality among CPR survivor with or without liver cirrhosis, adjusted with gender, race, primary payer, arrest rhythm, targeted temperature management and Charlson Comorbidity Index, except for chronic liver disease. Length of stay and the cost of admission were analyzed by generalized linear regression with gamma distribution and log-link.
Results: There were 25178 patients with IHCA identified in this study. Among them, there were 443 with alcoholic liver cirrhosis and 24735 without alcoholic liver cirrhosis. Alcoholic liver cirrhosis is associated with higher risk of mortality (81.9% vs 67.0%, adjusted OR 2.18, confidence interval [CI] 1.69-2.80, p< 0.001), high rate of non-shockable rhythm (81.9% vs 72.5%, p< 0.001). However, there was no significant difference between patient who receive target temperature therapy (1.7% vs 0.5%). length of stay (median 4 days vs 4 days), and cost per hospital day ($87147.50 vs $90637.00, p = 0.73).
Discussion: Our study showed that alcoholic cirrhosis is associated with higher risk of mortality and higher rate of non-shockable rhythm. Due to lack of laboratory value, the severity of cirrhosis in our patients is unknown. Although there were several cohort studies that showed increased mortality in all patient with cirrhosis and IHCA, there was limited study that focus on the effect of alcoholic cirrhosis on cardiac arrest.
Disclosures: Gin Yi Lee indicated no relevant financial relationships. Guangchen Zou indicated no relevant financial relationships. Tien-Chan Hsieh indicated no relevant financial relationships. Kaiqing Lin indicated no relevant financial relationships.
Gin Yi Lee, MD, Guangchen Zou, MD, Tien-Chan Hsieh, MD, Kaiqing Lin, MD. P2854 - Association of In-Hospital Cardiac Arrest Survivors with Alcoholic Liver Cirrhosis in the Era of Target Temperature Management, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.