Clinical and Laboratory Factors Associated With In-Hospital Mortality Among Patients With Decompensated Liver...

Liver cirrhosis is a major cause of morbidity and mortality worldwide. Identification of clinical and laboratory factors associated with mortality may help clinicians identify high-risk hospitalized patients with decompensated liver cirrhosis.

A retrospective cohort study was conducted among 190 patients with decompensated liver cirrhosis admitted to Adam Malik General Hospital, Medan, Indonesia, between January 2022 and December 2023. Demographic, clinical, and laboratory data were obtained from medical records. Bivariate analyses were performed using chi-square, Fisher's exact, and Mann-Whitney U tests as appropriate.

Among the 190 patients included in the study, 79 (41.6%) died during hospitalization. Bivariate analysis showed that grade III-IV hepatic encephalopathy, abnormal leukocyte count, low serum albumin levels, elevated total bilirubin, elevated serum creatinine, increased INR, hyponatremia, and higher albumin-bilirubin (ALBI) grade, Child-Pugh class, model for end-stage liver disease (MELD), and MELD sodium (MELD-Na) scores were significantly associated with in-hospital mortality (p < 0.05). In contrast, age, sex, comorbidities, and upper gastrointestinal bleeding at admission were not significantly associated with mortality.

In-hospital mortality among decompensated cirrhotic patients remains high. Several clinical and laboratory parameters, including hepatic encephalopathy, leukocyte count, albumin, bilirubin, creatinine, INR, and sodium levels, were significantly associated with mortality. Early recognition of these factors may help clinicians identify high-risk patients with decompensated liver cirrhosis during hospitalization.