Clinical course and short‐term mortality of cirrhotic patients with infections other than spontaneous bacterial peritonitis

Clinical course and risk factors of death in non-SBP infections are poorly known. We assessed the prevalence of AKI and type-1 HRS, hospital, 30-d and 90-d mortality and risk factors of death in 441 decompensated patients. Methods: Analysis of 615 non-SBP infections (161 urinary infections, 95 cellulitis, 92 suspected infections, 92 bacteremias, 84 pneumonias, 21 bronchitis, 18 cholangitis, 15 spontaneous empyema, 13 secondary peritonitis, 24 other). Results: 96% of infections solved. AKI and type-1 HRS developed in 37% and 9% of infections, respectively. Overall hospital, 30-d and 90-d mortality rates were 11%, 12% and 18%, respectively. Clinical course and mortality differed markedly across infections. Endocarditis, osteoarticular infections, pneumonia, spontaneous bacteremia, cholangitis, secondary peritonitis and UTI showed higher rates of AKI. Prevalence of type-1 HRS was not significantly different among infections. Endocarditis, secondary peritonitis, pneumonia and bacteremia showed lower rates of renal impairment resolution and higher hospital mortality associated to AKI (42% vs. 12%, p<0.0001) or type-1 HRS (71% vs. 27%, p=0.003) than the rest of infections. Age (HR: 1.04), serum sodium (HR: 0.91), serum bilirubin (HR: 1.06), INR (HR: 1.91), hepatic encephalopathy (HR: 2.44), ascites (HR: 3.06) and MDR isolation (HR: 2.27) at infection diagnosis were independent predictors of death during hospitalization. Conclusions: Non-SBP infections constitute a heterogeneous group regarding clinical course and prognosis. Endocarditis, secondary peritonitis, pneumonia and bacteremia show worse prognosis. The combination of data of liver and renal dysfunction and of the type of infection allows the identification of patients with poor prognosis. This article is protected by copyright. All rights reserved.