A 5-YEAR TREND OF NON-ALCOHOLIC LIVER CIRRHOSIS AND CARDIOGENIC SHOCK IN HEART FAILURE PATIENTS

Therapeutic Area

Heart Failure

Background

In heart failure (HF) patients, the intersection of non-alcoholic liver cirrhosis (NALC) and cardiogenic shock poses significant clinical challenges. Understanding the trends of these complications is essential for improving patient outcomes. This study examines the trend of NALC and its progression to cardiogenic shock among HF patients over a five-year period.

Methods

Data from the National Inpatient Sample (2016-2020) were analyzed to identify HF patients with NALC using ICD-10 codes. Trends were assessed using the Cochran-Armitage test for trend analysis and multivariable logistic regression to adjust for confounding factors. The year 2016 was the reference year for comparing data trends up to 2020. Outcomes are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and p-values.

Results

Out of 1,372,419 HF patients, 26,435 (1.9%) had NALC, with 1,180 (4.5%) experiencing cardiogenic shock with a mean age of 65 and predominantly male 59.3%. The rate of NALC among HF patients was 1.7% in 2016. By 2017, it increased to 2.0% (OR 1.2, 95% CI 1.20–1.31, p<0.001), 2.2% in 2018 (OR 1.3, 95% CI 1.17–1.42, p<0.001), 2.4% in 2019 (OR 1.5, 95% CI 1.31–1.60, p<0.001), and 2.7% in 2020 (OR 1.6, 95% CI 1.47–1.79, p<0.001), indicating an upward trend (trend p<0.001). Cardiogenic shock rates in patients with NALC were 3.53% in 2016, increasing to 4.32% in 2017 (OR 1.2, 95% CI 0.83–1.83, p=0.3) compared to 3.1% in patients without NALC, 4.73% in 2018 (OR 1.3, 95% CI 0.85–2.1, p=0.2) compared to 4.5%, 6.93% in 2019 (OR 1.5, 95% CI 1.37–3.02, p<0.001) compared to 5.6%, and 6.60% in 2020 (OR 1.6, 95% CI 1.25–2.88, p=0.003) compared to 6.4%, showing an increase trend (trend p<0.001). Overall, Cardiogenic shock OR was 1.5 (95% CI 1.31–1.70, p<0.001).

Conclusions

The study highlights the increasing trend of NALC and a concurrent increase in the rate of cardiogenic shock among patients with HF. This underscores the importance of vigilant monitoring and targeted intervention in effectively managing the HF population.