Effect of liver cirrhosis on long-term outcomes after acute respiratory failure: A population-based study

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.

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.

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).

LC, especially non-cryptogenic LC, significantly increases the risk of death after a 1-MV.