Limits...
Increased occurrence of native septic arthritis in adult cirrhotic patients: a population-based three-year follow-up study in Taiwan.

Hung TH, Hsieh MH, Lay CJ, Tsai CC, Tsai CC - Prz Gastroenterol (2014)

Bottom Line: After adjustment for age, gender, and other comorbid disorders, Cox's regression analysis showed that cirrhotic patients had a higher occurrence of NSA than non-cirrhotic patients(hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.19-1.90; p = 0.001).The patients with complicated cirrhosis were more prone to have NSA than those with non-complicated cirrhosis (HR = 1.46, 95% CI = 1.09-1.96, p = 0.011).This analysis demonstrates that cirrhotic patients have a higher risk of NSA, particularly those with complicated cirrhosis.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan ; School of Medicine, Tzu Chi University, Hualien, Taiwan.

ABSTRACT

Introduction: Due to impairment of immunity and metabolism, cirrhotic patients are prone to infection, osteoporosis, and osteonecrosis. However, it is unknown if cirrhotic patients are prone to native septic arthritis (NSA).

Aim: To assess the occurrence of NSA between cirrhotic and non-cirrhotic patients.

Material and methods: We used the Taiwan National Health Insurance Database to enrol 35,106 cirrhotic patients and 33,457 non-cirrhotic patients from January 1, 2004 to December 31, 2004. The medical record of each patient was individually followed for a 3-year period.

Results: There were 341 (0.5%) patients having NSA in a follow-up period of 3 years: 214 cirrhotic and 127 non-cirrhotic patients. The incidence density of hospitalisation for NSA was 2.03 episodes/1000 person-years in cirrhotic patients, and 1.27 episodes/1000 person-years in non-cirrhotic patients. After adjustment for age, gender, and other comorbid disorders, Cox's regression analysis showed that cirrhotic patients had a higher occurrence of NSA than non-cirrhotic patients(hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.19-1.90; p = 0.001). The patients with complicated cirrhosis were more prone to have NSA than those with non-complicated cirrhosis (HR = 1.46, 95% CI = 1.09-1.96, p = 0.011).

Conclusions: This analysis demonstrates that cirrhotic patients have a higher risk of NSA, particularly those with complicated cirrhosis.

No MeSH data available.


Related in: MedlinePlus

Time to hospitalisation for native septic arthritis in complicated cirrhotic patients (n = 7889), non-complicated cirrhotic patients (n = 27,217), and comparison patients (n = 33,457) over a period of 3 years. The proportions of complicated cirrhotic patients, non-complicated cirrhotic patients, and comparison patients with native septic arthritis over a period of 3 years were 0.84%, 0.54%, and 0.38%, respectively (p < 0.01)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4300349&req=5

Figure 0001: Time to hospitalisation for native septic arthritis in complicated cirrhotic patients (n = 7889), non-complicated cirrhotic patients (n = 27,217), and comparison patients (n = 33,457) over a period of 3 years. The proportions of complicated cirrhotic patients, non-complicated cirrhotic patients, and comparison patients with native septic arthritis over a period of 3 years were 0.84%, 0.54%, and 0.38%, respectively (p < 0.01)

Mentions: Because the severity of cirrhosis could not be identified from our database, we selected refractory ascites, oesophageal/gastric variceal bleedings, and hepatic encephalopathy as the markers for severe cirrhosis. When the patients had had refractory ascites, episodes of oesophageal/gastric variceal bleeding, or episodes of hepatic encephalopathy, they were considered as having complicated cirrhosis. Of 35,106 cirrhotic patients, there were 7889 (22%) patients with complicated cirrhosis and 27,217 (78%) patients with non-complicated cirrhosis. The NSA occurred in 148 (0.5%) of the non-complicated cirrhotic patients and 66 (0.8%) of the complicated cirrhotic patients during a 3-year follow-up period. Compared with non-complicated cirrhosis, the crude HR of complicated liver cirrhosis for the occurrence of NSA in a period of 3 years was 1.54 (95% CI: 1.15–2.06; p = 0.003). After adjustment for gender, age group, and other confounding factors for NSA (i.e. DM, CRF, SLE, RA, gout, IVDA, and alcoholism), the HR of complicated cirrhosis was 1.46 (95% CI: 1.09–1.96; p = 0.011). Table III summarises the crude and adjusted HRs of complicated cirrhosis for septic arthritis compared with non-complicated cirrhosis. Figure 1 shows the plot of time to occurrence of NSA among non-cirrhotic patients, complicated cirrhotic patients, and non-complicated cirrhotic patients.


Increased occurrence of native septic arthritis in adult cirrhotic patients: a population-based three-year follow-up study in Taiwan.

Hung TH, Hsieh MH, Lay CJ, Tsai CC, Tsai CC - Prz Gastroenterol (2014)

Time to hospitalisation for native septic arthritis in complicated cirrhotic patients (n = 7889), non-complicated cirrhotic patients (n = 27,217), and comparison patients (n = 33,457) over a period of 3 years. The proportions of complicated cirrhotic patients, non-complicated cirrhotic patients, and comparison patients with native septic arthritis over a period of 3 years were 0.84%, 0.54%, and 0.38%, respectively (p < 0.01)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300349&req=5

Figure 0001: Time to hospitalisation for native septic arthritis in complicated cirrhotic patients (n = 7889), non-complicated cirrhotic patients (n = 27,217), and comparison patients (n = 33,457) over a period of 3 years. The proportions of complicated cirrhotic patients, non-complicated cirrhotic patients, and comparison patients with native septic arthritis over a period of 3 years were 0.84%, 0.54%, and 0.38%, respectively (p < 0.01)
Mentions: Because the severity of cirrhosis could not be identified from our database, we selected refractory ascites, oesophageal/gastric variceal bleedings, and hepatic encephalopathy as the markers for severe cirrhosis. When the patients had had refractory ascites, episodes of oesophageal/gastric variceal bleeding, or episodes of hepatic encephalopathy, they were considered as having complicated cirrhosis. Of 35,106 cirrhotic patients, there were 7889 (22%) patients with complicated cirrhosis and 27,217 (78%) patients with non-complicated cirrhosis. The NSA occurred in 148 (0.5%) of the non-complicated cirrhotic patients and 66 (0.8%) of the complicated cirrhotic patients during a 3-year follow-up period. Compared with non-complicated cirrhosis, the crude HR of complicated liver cirrhosis for the occurrence of NSA in a period of 3 years was 1.54 (95% CI: 1.15–2.06; p = 0.003). After adjustment for gender, age group, and other confounding factors for NSA (i.e. DM, CRF, SLE, RA, gout, IVDA, and alcoholism), the HR of complicated cirrhosis was 1.46 (95% CI: 1.09–1.96; p = 0.011). Table III summarises the crude and adjusted HRs of complicated cirrhosis for septic arthritis compared with non-complicated cirrhosis. Figure 1 shows the plot of time to occurrence of NSA among non-cirrhotic patients, complicated cirrhotic patients, and non-complicated cirrhotic patients.

Bottom Line: After adjustment for age, gender, and other comorbid disorders, Cox's regression analysis showed that cirrhotic patients had a higher occurrence of NSA than non-cirrhotic patients(hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.19-1.90; p = 0.001).The patients with complicated cirrhosis were more prone to have NSA than those with non-complicated cirrhosis (HR = 1.46, 95% CI = 1.09-1.96, p = 0.011).This analysis demonstrates that cirrhotic patients have a higher risk of NSA, particularly those with complicated cirrhosis.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan ; School of Medicine, Tzu Chi University, Hualien, Taiwan.

ABSTRACT

Introduction: Due to impairment of immunity and metabolism, cirrhotic patients are prone to infection, osteoporosis, and osteonecrosis. However, it is unknown if cirrhotic patients are prone to native septic arthritis (NSA).

Aim: To assess the occurrence of NSA between cirrhotic and non-cirrhotic patients.

Material and methods: We used the Taiwan National Health Insurance Database to enrol 35,106 cirrhotic patients and 33,457 non-cirrhotic patients from January 1, 2004 to December 31, 2004. The medical record of each patient was individually followed for a 3-year period.

Results: There were 341 (0.5%) patients having NSA in a follow-up period of 3 years: 214 cirrhotic and 127 non-cirrhotic patients. The incidence density of hospitalisation for NSA was 2.03 episodes/1000 person-years in cirrhotic patients, and 1.27 episodes/1000 person-years in non-cirrhotic patients. After adjustment for age, gender, and other comorbid disorders, Cox's regression analysis showed that cirrhotic patients had a higher occurrence of NSA than non-cirrhotic patients(hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.19-1.90; p = 0.001). The patients with complicated cirrhosis were more prone to have NSA than those with non-complicated cirrhosis (HR = 1.46, 95% CI = 1.09-1.96, p = 0.011).

Conclusions: This analysis demonstrates that cirrhotic patients have a higher risk of NSA, particularly those with complicated cirrhosis.

No MeSH data available.


Related in: MedlinePlus