P133 | Bacterial infections as an increasing cause of decompensation in liver cirrhosis patients: a prospective analysis of admissions to an Internal Medicine unit from 2014 to 2023

M. Salvati¹, V. Tommasi², D. Manfellotto², L. Carbone², P. Piccolo² | ¹Medicina Interna, Università Campus Bio-Medico, Roma, ²Medicina Interna, Ospedale Isola Tiberina Gemelli-Isola, Roma, Italy

Background: Decompensation is a key prognostic event in the natural history of liver cirrhosis. Cirrhotic patients admitted to Internal Medicine (IM) Units may present one or more decompensating events, which impact mortality. In this prospective study, we analyse the causes of admission and outcomes of cirrhotic patients in a secondary hospital in Rome, Italy.
Methods: All admissions to IM during 2014-2023 were prospectively recorded along with demographic data, diagnosis, hospital stay and outcome. Patients with cirrhosis were retrospectively analysed for decompensation events, comorbidities, and clinical outcomes. Results: 372 admissions due to cirrhosis were included (88% from the Emergency Department, 66.1% males, median age 71 years, IQR 23). Decompensating events requiring admission were: ascites 33.5%, hepatic encephalopathy 28.7%, bacterial infection 20.2%, bleeding 19.2%, acute kidney injury 13.3%. At least two decompensating events were present in 21.8%. Concomitant HCC was present in 24.7% and diabetes mellitus in 28%. Mean hospital stay was 10.3±8 days and in-hospital mortality was 9.4% overall. Patients admitted for bacterial infection had longer hospital stay (14.8±11.8 days, p=0.001) as well as patients with more than one event (13.3±10.3 days, p=0.03).
Conclusions: Among cirrhotic patients, bacterial infections are emerging as an important precipitating event for decompensation requiring hospitalization; presence of infection also increased duration of hospital stay in our cohort.