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. Three main 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 post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.
| Lingua originale | Inglese |
|---|---|
| pagine (da-a) | 498-504 |
| Numero di pagine | 7 |
| Rivista | Age and Ageing |
| Volume | 50 |
| Numero di pubblicazione | 2 |
| DOI | |
| Stato di pubblicazione | Pubblicato - 1 mar 2021 |
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In: Age and Ageing, Vol. 50, N. 2, 01.03.2021, pag. 498-504.
Risultato della ricerca: Contributo su rivista › Articolo in rivista › peer review
TY - JOUR
T1 - The multifaceted spectrum of liver cirrhosis in older hospitalised patients
T2 - Analysis of the REPOSI registry
AU - De Vincentis, Antonio
AU - Vespasiani-Gentilucci, Umberto
AU - Costanzo, Luisa
AU - Novella, Alessio
AU - Cortesi, Laura
AU - Nobili, Alessandro
AU - Mannucci, Pier Mannuccio
AU - Incalzi, Raffaele Antonelli
AU - Nobili, Alessandro
AU - Pietrangelo, Antonello
AU - Perticone, Francesco
AU - Licata, Giuseppe
AU - Violi, Francesco
AU - Corazza, Gino Roberto
AU - Corrao, Salvatore
AU - Marengoni, Alessandra
AU - Salerno, Francesco
AU - Cesari, Matteo
AU - Tettamanti, Mauro
AU - Pasina, Luca
AU - Franchi, Carlotta
AU - Franchi, Carlotta
AU - Cortesi, Laura
AU - Miglio, Gabriella
AU - Cortesi, Laura
AU - Ardoino, Ilaria
AU - Novella, Alessio
AU - Prisco, Domenico
AU - Silvestri, Elena
AU - Emmi, Giacomo
AU - Bettiol, Alessandra
AU - Mattioli, Irene
AU - Biolo, Gianni
AU - Zanetti, Michela
AU - Bartelloni, Giacomo
AU - Vanoli, Massimo
AU - Grignani, Giulia
AU - Pulixi, Edoardo Alessandro
AU - Lupattelli, Graziana
AU - Bianconi, Vanessa
AU - Alcidi, Riccardo
AU - Girelli, Domenico
AU - Busti, Fabiana
AU - Marchi, Giacomo
AU - Barbagallo, Mario
AU - Dominguez, Ligia
AU - Beneduce, Vincenza
AU - Cacioppo, Federica
AU - Natoli, Giuseppe
AU - Mularo, Salvatore
AU - Raspanti, Massimo
AU - Zoli, Marco
AU - Matacena, Maria Laura
AU - Orio, Giuseppe
AU - Magnolfi, Eleonora
AU - Serafini, Giovanni
AU - Simili, Angelo
AU - Palasciano, Giuseppe
AU - Modeo, Maria Ester
AU - Gennaro, Carla Di
AU - Cappellini, Maria Domenica
AU - Fabio, Giovanna
AU - De Amicis, Margherita Migone
AU - De Luca, Giacomo
AU - Scaramellini, Natalia
AU - Rossi, Paolo Dionigi
AU - Damanti, Sarah
AU - Clerici, Marta
AU - Leoni, Simona
AU - Di Mauro, Alessandra Danuta
AU - Di Sabatino, Antonio
AU - Miceli, Emanuela
AU - Lenti, Marco Vincenzo
AU - Pisati, Martina
AU - Dominioni, Costanza Caccia
AU - Pontremoli, Roberto
AU - Beccati, Valentina
AU - Nobili, Giulia
AU - Leoncini, Giovanna
AU - Anastasio, Luigi
AU - Carbone, Maria
AU - Cipollone, Francesco
AU - Guagnano, Maria Teresa
AU - Rossi, Ilaria
AU - Mancuso, Gerardo
AU - Calipari, Daniela
AU - Bartone, Mosè
AU - Delitala, Giuseppe
AU - Berria, Maria
AU - Delitala, Alessandro
AU - Muscaritoli, Maurizio
AU - Molfino, Alessio
AU - Petrillo, Enrico
AU - Giorgi, Antonella
AU - Gracin, Christian
AU - Zuccalà, Giuseppe
AU - D'Aurizio, Gabriella
AU - Romanelli, Giuseppe
AU - Volpini, Andrea
AU - Lucente, Daniela
AU - Picardi, Antonio
AU - Bellelli, Giuseppe
AU - Corsi, Maurizio
AU - Antonucci, Cesare
AU - Sidoli, Chiara
AU - Principato, Giulia
AU - Arturi, Franco
AU - Succurro, Elena
AU - Tassone, Bruno
AU - Giofrè, Federica
AU - Serra, Maria Grazia
AU - Bleve, Maria Antonietta
AU - Brucato, Antonio
AU - De Falco, Teresa
AU - Fabris, Fabrizio
AU - Bertozzi, Irene
AU - Bogoni, Giulia
AU - Rabuini, Maria Victoria
AU - Prandini, Tancredi
AU - Manfredini, Roberto
AU - Fabbian, Fabio
AU - Boari, Benedetta
AU - De Giorgi, Alfredo
AU - Tiseo, Ruana
AU - Paolisso, Giuseppe
AU - Rizzo, Maria Rosaria
AU - Catalano, Claudia
AU - Borghi, Claudio
AU - Strocchi, Enrico
AU - Ianniello, Eugenia
AU - Soldati, Mario
AU - Schiavone, Silvia
AU - Bragagni, Alessio
AU - Sabbà, Carlo
AU - Vella, Francesco Saverio
AU - Suppressa, Patrizia
AU - De Vincenzo, Giovanni Michele
AU - Comitangelo, Alessio
AU - Amoruso, Emanuele
AU - Custodero, Carlo
AU - Fenoglio, Luigi
AU - Falcetta, Andrea
AU - Fracanzani, Anna L.
AU - Tiraboschi, Silvia
AU - Cespiati, Annalisa
AU - Oberti, Giovanna
AU - Sigon, Giordano
AU - Peyvandi, Flora
AU - Rossio, Raffaella
AU - Colombo, Giulia
AU - Agosti, Pasquale
AU - Monzani, Valter
AU - Savojardo, Valeria
AU - Ceriani, Giuliana
AU - Salerno, Francesco
AU - Pallini, Giada
AU - Montecucco, Fabrizio
AU - Ottonello, Luciano
AU - Caserza, Lara
AU - Vischi, Giulia
AU - Liberato, Nicola Lucio
AU - Tognin, Tiziana
AU - Purrello, Francesco
AU - Di Pino, Antonino
AU - Piro, Salvatore
AU - Rozzini, Renzo
AU - Falanga, Lina
AU - Pisciotta, Maria Stella
AU - Bellucci, Francesco Baffa
AU - Buffelli, Stefano
AU - Montrucchio, Giuseppe
AU - Peasso, Paolo
AU - Favale, Edoardo
AU - Poletto, Cesare
AU - Margaria, Carl
AU - Sanino, Maura
AU - Perri, Ludovica
AU - Guasti, Luigina
AU - Castiglioni, Luana
AU - Maresca, Andrea
AU - Squizzato, Alessandro
AU - Campiotti, Leonardo
AU - Grossi, Alessandra
AU - Diprizio, Roberto Davide
AU - Bertolotti, Marco
AU - Mussi, Chiara
AU - Lancellotti, Giulia
AU - Libbra, Maria Vittoria
AU - Galassi, Matteo
AU - Grassi, Yasmine
AU - Greco, Alessio
AU - Sciacqua, Angela
AU - Perticone, Maria
AU - Battaglia, Rosa
AU - Maio, Raffaele
AU - Stanghellini, Vincenzo
AU - Ruggeri, Eugenio
AU - Del Vecchio, Sara
AU - Salvi, Andrea
AU - Leonardi, Roberto
AU - Damiani, Giampaolo
AU - Capeci, William
AU - Mattioli, Massimo
AU - Martino, Giuseppe Pio
AU - Biondi, Lorenzo
AU - Pettinari, Pietro
AU - Ghio, Riccardo
AU - Col, Anna Dal
AU - Minisola, Salvatore
AU - Colangelo, Luciano
AU - Cilli, Mirella
AU - Labbadia, Giancarlo
AU - Afeltra, Antonella
AU - Pipita, Maria Elena
AU - Castellino, Pietro
AU - Zanoli, Luca
AU - Gennaro, Alfio
AU - Gaudio, Agostino
AU - Saracco, Valter
AU - Fogliati, Marisa
AU - Bussolino, Carlo
AU - Mete, Francesca
AU - Gino, Miriam
AU - Vigorito, Carlo
AU - Cittadini, Antonio
AU - Moreo, Guido
AU - Prolo, Silvia
AU - Pina, Gloria
AU - Ballestrero, Alberto
AU - Ferrando, Fabio
AU - Gonella, Roberta
AU - Cerminara, Domenico
AU - Berra, Sergio
AU - Dassi, Simonetta
AU - Nava, Maria Cristina
AU - Graziella, Bruno
AU - Baldassarre, Stefano
AU - Fragapani, Salvatore
AU - Gruden, Gabriella
AU - Galanti, Giorgio
AU - Mascherini, Gabriele
AU - Petri, Cristian
AU - Stefani, Laura
AU - Girino, Margherita
AU - Piccinelli, Valeria
AU - Nasso, Francesco
AU - Gioffrè, Vincenza
AU - Pasquale, Maria
AU - Sechi, Leonardo
AU - Catena, Cristiana
AU - Colussi, Gianluca
AU - Cavarape, Alessandro
AU - Da Porto, Andea
AU - Passariello, Nicola
AU - Rinaldi, Luca
AU - Berti, Franco
AU - Famularo, Giuseppe
AU - Tarsitani, Patrizia
AU - Castello, Roberto
AU - Pasino, Michela
AU - Ceda, Gian Paolo
AU - Maggio, Marcello Giuseppe
AU - Morganti, Simonetta
AU - Artoni, Andrea
AU - Grossi, Margherita
AU - Del Giacco, Stefano
AU - Firinu, Davide
AU - Costanzo, Giulia
AU - Argiolas, Giacomo
AU - Montalto, Giuseppe
AU - Licata, Anna
AU - Montalto, Filippo Alessandro
AU - Corica, Francesco
AU - Basile, Giorgio
AU - Catalano, Antonino
AU - Bellone, Federica
AU - Principato, Concetto
AU - Malatino, Lorenzo
AU - Stancanelli, Benedetta
AU - Terranova, Valentina
AU - Di Marca, Salvatore
AU - Di Quattro, Rosario
AU - Malfa, Lara La
AU - Caruso, Rossella
AU - Mecocci, Patrizia
AU - Ruggiero, Carmelinda
AU - Boccardi, Virginia
AU - Meschi, Tiziana
AU - Ticinesi, Andrea
AU - Nouvenne, Antonio
AU - Minuz, Pietro
AU - Fondrieschi, Luigi
AU - Imperiale, Giandomenico Nigro
AU - Pirisi, Mario
AU - Fra, Gian Paolo
AU - Sola, Daniele
AU - Bellan, Mattia
AU - Porta, Massimo
AU - Riva, Piero
AU - Quadri, Roberto
AU - Larovere, Erica
AU - Novelli, Marco
AU - Scanzi, Giorgio
AU - Mengoli, Caterina
AU - Provini, Stella
AU - Ricevuti, Laura
AU - Simeone, Emilio
AU - Scurti, Rosa
AU - Tolloso, Fabio
AU - Tarquini, Roberto
AU - Valoriani, Alice
AU - Dolenti, Silvia
AU - Vannini, Giulia
AU - Volpi, Riccardo
AU - Bocchi, Pietro
AU - Vignali, Alessandro
AU - Harari, Sergio
AU - Lonati, Chiara
AU - Napoli, Federico
AU - Aiello, Italia
AU - Landolfi, Raffaele
AU - Montalto, Massimo
AU - Mirijello, Antonio
AU - Purrello, Francesco
AU - Del Primario, Nome E.Cognome
AU - Ghidoni, Silvia
AU - Salvatore, Teresa
AU - Monaco, Lucio
AU - Ricozzi, Carmen
AU - Pilotto, Alberto
AU - Indiano, Ilaria
AU - Gandolfo, Federica
N1 - Publisher Copyright: © 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: [email protected].
PY - 2021/3/1
Y1 - 2021/3/1
N2 - 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. Three main 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 post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.
AB - 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. Three main 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 post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.
KW - disability
KW - hospitalisation
KW - liver cirrhosis
KW - mortality
KW - older people
KW - phenotypes
UR - http://www.scopus.com/inward/record.url?scp=85102657737&partnerID=8YFLogxK
U2 - 10.1093/ageing/afaa150
DO - 10.1093/ageing/afaa150
M3 - Article
SN - 0002-0729
VL - 50
SP - 498
EP - 504
JO - Age and Ageing
JF - Age and Ageing
IS - 2
ER -