Background: Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce.Objectives: To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties.Methods: A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed.Results: LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Threemain clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P < 0.05) compared to FIT. D&M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P < 0.01; post-discharge: 41% vs 12%/15%, P < 0.01) and less rehospitalisation (10% vs 32%/34%, P < 0.01) compared to PSS and FIT.Conclusions: LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse postdischarge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.
The multifaceted spectrum of liver cirrhosis in older hospitalised patients: analysis of the REPOSI registry / De Vincentis, Antonio; Vespasiani-Gentilucci, Umberto; Costanzo, Luisa; Novella, Alessio; Cortesi, Laura; Nobili, Alessandro; Mannucci, Pier Mannuccio; Incalzi, Raffaele Antonelli; Null, Null; Mannucci, Pier Mannuccio; Nobili, Alessandro; Pietrangelo, Antonello; Perticone, Francesco; Licata, Giuseppe; Violi, Francesco; Corazza, Gino Roberto; Corrao, Salvatore; Marengoni, Alessandra; Salerno, Francesco; Cesari, Matteo; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Franchi, Carlotta; Cortesi, Laura; Tettamanti, Mauro; Miglio, Gabriella; Tettamanti, Mauro; Cortesi, Laura; Ardoino, Ilaria; Novella, Alessio; Prisco, Domenico; Silvestri, Elena; Emmi, Giacomo; Bettiol, Alessandra; Mattioli, Irene; Biolo, Gianni; Zanetti, Michela; Bartelloni, Giacomo; Vanoli, Massimo; Grignani, Giulia; Pulixi, Edoardo Alessandro; Lupattelli, Graziana; Bianconi, Vanessa; Alcidi, Riccardo; Girelli, Domenico; Busti, Fabiana; Marchi, Giacomo; Barbagallo, Mario; Dominguez, Ligia; Beneduce, Vincenza; Cacioppo, Federica; Corrao, Salvatore; Natoli, Giuseppe; Mularo, Salvatore; Raspanti, Massimo; Zoli, Marco; Matacena, Maria Laura; Orio, Giuseppe; Magnolfi, Eleonora; Serafini, Giovanni; Simili, Angelo; Palasciano, Giuseppe; Modeo, Maria Ester; Gennaro, Carla Di; Cappellini, Maria Domenica; Fabio, Giovanna; De Amicis, Margherita Migone; De Luca, Giacomo; Scaramellini, Natalia; Cesari, Matteo; Rossi, Paolo Dionigi; Damanti, Sarah; Clerici, Marta; Leoni, Simona; Di Mauro, Alessandra Danuta; Di Sabatino, Antonio; Miceli, Emanuela; Lenti, Marco Vincenzo; Pisati, Martina; Dominioni, Costanza Caccia; Pontremoli, Roberto; Beccati, Valentina; Nobili, Giulia; Leoncini, Giovanna; Anastasio, Luigi; Carbone, Maria; Cipollone, Francesco; Guagnano, Maria Teresa; Rossi, Ilaria; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Delitala, Giuseppe; Berria, Maria; Delitala, Alessandro; Muscaritoli, Maurizio; Molfino, Alessio; Petrillo, Enrico; Giorgi, Antonella; Gracin, Christian; Zuccalà, Giuseppe; D'Aurizio, Gabriella; Romanelli, Giuseppe; Marengoni, Alessandra; Volpini, Andrea; Lucente, Daniela; Picardi, Antonio; Gentilucci, Umberto Vespasiani; Bellelli, Giuseppe; Corsi, Maurizio; Antonucci, Cesare; Sidoli, Chiara; Principato, Giulia; Arturi, Franco; Succurro, Elena; Tassone, Bruno; Giofrè, Federica; Serra, Maria Grazia; Bleve, Maria Antonietta; Brucato, Antonio; De Falco, Teresa; Fabris, Fabrizio; Bertozzi, Irene; Bogoni, Giulia; Rabuini, Maria Victoria; Prandini, Tancredi; Manfredini, Roberto; Fabbian, Fabio; Boari, Benedetta; De Giorgi, Alfredo; Tiseo, Ruana; Paolisso, Giuseppe; Rizzo, Maria Rosaria; Catalano, Claudia; Borghi, Claudio; Strocchi, Enrico; Ianniello, Eugenia; Soldati, Mario; Schiavone, Silvia; Bragagni, Alessio; Sabbà, Carlo; Vella, Francesco Saverio; Suppressa, Patrizia; De Vincenzo, Giovanni Michele; Comitangelo, Alessio; Amoruso, Emanuele; Custodero, Carlo; Fenoglio, Luigi; Falcetta, Andrea; Fracanzani, Anna L; Tiraboschi, Silvia; Cespiati, Annalisa; Oberti, Giovanna; Sigon, Giordano; Peyvandi, Flora; Rossio, Raffaella; Colombo, Giulia; Agosti, Pasquale; Monzani, Valter; Savojardo, Valeria; Ceriani, Giuliana; Salerno, Francesco; Pallini, Giada; Montecucco, Fabrizio; Ottonello, Luciano; Caserza, Lara; Vischi, Giulia; Liberato, Nicola Lucio; Tognin, Tiziana; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Rozzini, Renzo; Falanga, Lina; Pisciotta, Maria Stella; Bellucci, Francesco Baffa; Buffelli, Stefano; Montrucchio, Giuseppe; Peasso, Paolo; Favale, Edoardo; Poletto, Cesare; Margaria, Carl; Sanino, Maura; Violi, Francesco; Perri, Ludovica; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Campiotti, Leonardo; Grossi, Alessandra; Diprizio, Roberto Davide; Bertolotti, Marco; Mussi, Chiara; Lancellotti, Giulia; Libbra, Maria Vittoria; Galassi, Matteo; Grassi, Yasmine; Greco, Alessio; Sciacqua, Angela; Perticone, Maria; Battaglia, Rosa; Maio, Raffaele; Stanghellini, Vincenzo; Ruggeri, Eugenio; del Vecchio, Sara; Salvi, Andrea; Leonardi, Roberto; Damiani, Giampaolo; Capeci, William; Mattioli, Massimo; Martino, Giuseppe Pio; Biondi, Lorenzo; Pettinari, Pietro; Ghio, Riccardo; Col, Anna Dal; Minisola, Salvatore; Colangelo, Luciano; Cilli, Mirella; Labbadia, Giancarlo; Afeltra, Antonella; Pipita, Maria Elena; Castellino, Pietro; Zanoli, Luca; Gennaro, Alfio; Gaudio, Agostino; Saracco, Valter; Fogliati, Marisa; Bussolino, Carlo; Mete, Francesca; Gino, Miriam; Vigorito, Carlo; Cittadini, Antonio; Moreo, Guido; Prolo, Silvia; Pina, Gloria; Ballestrero, Alberto; Ferrando, Fabio; Gonella, Roberta; Cerminara, Domenico; Berra, Sergio; Dassi, Simonetta; Nava, Maria Cristina; Graziella, Bruno; Baldassarre, Stefano; Fragapani, Salvatore; Gruden, Gabriella; Galanti, Giorgio; Mascherini, Gabriele; Petri, Cristian; Stefani, Laura; Girino, Margherita; Piccinelli, Valeria; Nasso, Francesco; Gioffrè, Vincenza; Pasquale, Maria; Sechi, Leonardo; Catena, Cristiana; Colussi, Gianluca; Cavarape, Alessandro; Da Porto, Andea; Passariello, Nicola; Rinaldi, Luca; Berti, Franco; Famularo, Giuseppe; Tarsitani, Patrizia; Castello, Roberto; Pasino, Michela; Ceda, Gian Paolo; Maggio, Marcello Giuseppe; Morganti, Simonetta; Artoni, Andrea; Grossi, Margherita; Del Giacco, Stefano; Firinu, Davide; Costanzo, Giulia; Argiolas, Giacomo; Montalto, Giuseppe; Licata, Anna; Montalto, Filippo Alessandro; Corica, Francesco; Basile, Giorgio; Catalano, Antonino; Bellone, Federica; Principato, Concetto; Malatino, Lorenzo; Stancanelli, Benedetta; Terranova, Valentina; Di Marca, Salvatore; Di Quattro, Rosario; Malfa, Lara La; Caruso, Rossella; Mecocci, Patrizia; Ruggiero, Carmelinda; Boccardi, Virginia; Meschi, Tiziana; Ticinesi, Andrea; Nouvenne, Antonio; Minuz, Pietro; Fondrieschi, Luigi; Imperiale, Giandomenico Nigro; Pirisi, Mario; Fra, Gian Paolo; Sola, Daniele; Bellan, Mattia; Porta, Massimo; Riva, Piero; Quadri, Roberto; Larovere, Erica; Novelli, Marco; Scanzi, Giorgio; Mengoli, Caterina; Provini, Stella; Ricevuti, Laura; Simeone, Emilio; Scurti, Rosa; Tolloso, Fabio; Tarquini, Roberto; Valoriani, Alice; Dolenti, Silvia; Vannini, Giulia; Volpi, Riccardo; Bocchi, Pietro; Vignali, Alessandro; Harari, Sergio; Lonati, Chiara; Napoli, Federico; Aiello, Italia; Landolfi, Raffaele; Montalto, Massimo; Mirijello, Antonio; Purrello, Francesco; Di Pino, Antonino; del Primario, Nome e Cognome; Ghidoni, Silvia; Salvatore, Teresa; Monaco, Lucio; Ricozzi, Carmen; Pilotto, Alberto; Indiano, Ilaria; Gandolfo, Federica. - In: AGE AND AGEING. - ISSN 0002-0729. - 50:2(2021), pp. 498-504. [10.1093/ageing/afaa150]
The multifaceted spectrum of liver cirrhosis in older hospitalised patients: analysis of the REPOSI registry
De Luca, Giacomo;Damanti, Sarah;Pasquale, Maria;
2021-01-01
Abstract
Background: Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce.Objectives: To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties.Methods: A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed.Results: LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Threemain clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P < 0.05) compared to FIT. D&M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P < 0.01; post-discharge: 41% vs 12%/15%, P < 0.01) and less rehospitalisation (10% vs 32%/34%, P < 0.01) compared to PSS and FIT.Conclusions: LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse postdischarge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
