Clinical Features And A Case-control Study For Infection Risk Factors Of Decompensate Cirrhosis

Purpose: To explore the clinical features and the risk factors for infectionin patients with decompensate cirrhosis, and to provide important basisfor reducing the occurrence rate of infection and improve the life qualityof patients.Method: A total of1010patients with decompensate cirrhosis werecollected in our hospital during October2010to September2012.Retrospectively analyzed the infection in decompensate cirrhosisincluding the sites, bacterial culture results and prognosis of infections etc.A case-controlled study was employed to retrospectively analyze theinfection and the risk factors. According to1:1case-control study,adopted353cases as non-infection group. The multiple factors Logisticregression analysis was used to compute the relevant associations amongthe variables by SPSS18.0statistical s oftware.Result:(1) Infections developed in353patients with decompensatecirrhosis (34.95%), nosocomial infection, community infection, andmixed infection were149,192and12cases, respectively. The infectionrate of patients with alcoholic cirrhosis was significantly higher thanHepatitis B-related Cirrhosis.(2)This study revealed infections in decompensate cirrhosis occurred mainly in the lungs, followed by peritoneal cavity, intestinaltract and biliary tract, etc.151strains of pathogenic bacteria were isolatedfrom infection group of patients. Among which Gram-negative bacteriawere73strains (48.34%); gram-positive bacteria were20strains(13.25%); Fungi were58strains(38.41%).(3) The results of multiple factors logistic regression showed thatthe following were risk factors for Decompensate Cirrhosis infection:hepatic encephalopathy (OR=36.314; P=0.000), gastrointestinal bleeding(OR=36.222; P=0.000), liver function Child-Pugh grade (OR=6.842;P=0.000), age (OR=1.024; P=0.001), length of hospital stay (OR=1.018;P=0.030), serum albumin levels (OR=0.944; P=0.001), prophylactic useof antibiotics (OR=0.012; P=0.000).(4) The fatality rate of decompensated cirrhosis in the infectiongroup was higher than that in non-infection group (11.05%vs.2.83%,χ2=18.443, P<0.05).Conclusion:(1) The infection rate of patients with decompensatecirrhosis was as high as34.95%. Pulmonary infection occurred mostfrequently. The pathogenic bacteria isolated from infected areas weremainly gram-negative bacteria.(2) Patients who undergo older age,longer hospital staying, poorer Child-Pugh grade, as well as patients whowere supervening gastrointestinal bleeding or hepatic encephalopathy,were easier to develop infection. The prophylactic use of antibiotics contributes to reducing the occurrence of infection.(3) The fatality rate ofdecompensated cirrhosis in the infection group was higher than that innon-infection group.