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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Effect of liver cirrhosis on long-term outcomes after acute respiratory failure: A population-based study
Chih-Cheng Lai, Chung-Han Ho, Kuo-Chen Cheng, Chien-Ming Chao, Chin-Ming Chen, Willy Chou
Chih-Cheng Lai, Chien-Ming Chao, Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan 736, Taiwan
Chung-Han Ho, Departments of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
Kuo-Chen Cheng, Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan
Kuo-Chen Cheng, Department of Safety, Health and Environment, Chung Hwa University of Medical Technology, Tainan 717, Taiwan
Chin-Ming Chen, Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan 710, Taiwan
Chin-Ming Chen, Willy Chou, Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
Author contributions: Chen CM is the guarantor of this manuscript; Lai CC, Ho CH, Cheng KC, Chao CM and Chou W contributed to the conception and design of the study; Ho CH analyzed and interpreted the data; Lai CC and Chen CM drafted the manuscript.
Institutional review board statement: The study was approved by the Institutional Review Board (IRB 10409-E04) at Chi Mei Medical Center.
Informed consent statement: Because the data used in this study have been deidentified and released to the public for research purposes, the need for informed consent from enrolled patients was waived by the Institutional Review Board at Chi Mei Medical Center.
Conflict-of-interest statement: All authors declared there is no conflict of interest.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at chencm3383@yahoo.com.tw.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chin-Ming Chen, MD, Department of Intensive Care Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang Dist., Tainan 710, Taiwan. chencm3383@yahoo.com.tw
Telephone: +886-6-2812811 Fax: +886-6-2812811
Received: December 23, 2016
Peer-review started: December 24, 2016
First decision: January 19, 2017
Revised: February 2, 2017
Accepted: March 2, 2017
Article in press: March 2, 2017
Published online: March 28, 2017
AIM
To assessed the effect of liver cirrhosis (LC) on the poorly understood long-term mortality risk after first-ever mechanical ventilation (1-MV) for acute respiratory failure.
METHODS
All patients in Taiwan given a 1-MV between 1997 and 2013 were identified in Taiwan’s Longitudinal Health Insurance Database 2000. Each patient with LC was individually matched, using a propensity-score method, to two patients without LC. The primary outcome was death after a 1-MV.
RESULTS
A total of 16653 patients were enrolled: 5551 LC-positive (LC[Pos]) patients, including 1732 with cryptogenic LCs and 11102 LC-negative (LC[Neg]) controls. LC[Pos] patients had more organ failures and were more likely to be admitted to medical department than were LC[Neg] controls. LC[Pos] patients had a significantly lower survival rate (AHR = 1.38, 95%CI: 1.32-1.44). Moreover, the mortality risk was significantly higher for patients with non-cryptogenic LC than for patients with cryptogenic LC (AHR = 1.43, 95%CI: 1.32-1.54) and patients without LC (AHR = 1.56, 95%CI: 1.32-1.54). However, there was no significant difference between patients with cryptogenic and without LC (HR = 1.05, 95%CI: 0.98-1.12).
CONCLUSION
LC, especially non-cryptogenic LC, significantly increases the risk of death after a 1-MV.
Core tip: Liver cirrhosis, especially non-cryptogenic liver cirrhosis, significantly increases the risk of death after acute respiratory failure.
