BACKGROUND AND AIMS The nature and outcomes of infection among patients with cirrhosis in safety-net hospitals are not well described. We aimed to characterize the rate of and risk factors for infection, both present on admission and nosocomial, in this unique population. We hypothesized that infections would be associated with adverse outcomes such as short-term mortality. METHODS We used descriptive statistics to characterize infections within a retrospective cohort characterized previously. We used multivariable logistic regression models to assess potential risk factors for infection and associations with key outcomes such as short-term mortality and length of stay. RESULTS The study cohort of 1112 patients included 33% women with a mean age of 56 ± 10 years. Infections were common (20%), with respiratory and urinary tract infections the most frequent. We did not observe a difference in the incidence of infection on admission based on patient demographic factors such as race/ethnicity or estimated household income. Infections on admission were associated with greater short-term mortality (12% vs 4% in-hospital and 14% vs 7% 30-day), longer length of stay (6 vs 3 days), intensive care unit admission (28% vs 18%), and acute-on-chronic liver failure (10% vs 2%) (p < 0.01 for all). Nosocomial infections were relatively uncommon (4%), but more frequent among patients admitted to the intensive care unit. Antibiotic resistance was common (38%), but not associated with negative outcomes. CONCLUSION We did not identify demographic risk factors for infection, but did confirm its morbid effect among patients with cirrhosis in safety-net hospitals.

中文翻译：

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与肝硬化患者的其他特征相比，MELD-Na与感染风险和结果的关联更紧密。

背景和目的在安全网医院中，肝硬化患者感染的性质和结果尚未得到很好的描述。我们旨在表征这种独特人群中入院时和医院内均存在的感染率和危险因素。我们假设感染将与不良后果如短期死亡相关。方法我们使用描述性统计量来表征先前表征的回顾性队列中的感染。我们使用多变量logistic回归模型评估感染的潜在危险因素以及与诸如短期死亡率和住院时间等关键结果的关联。结果该研究队列的1112名患者中，有33％的女性平均年龄为56±10岁。感染很普遍（20％），以呼吸道和泌尿道感染最为常见。根据患者的人口统计学因素（例如种族/民族或估计的家庭收入），我们并未观察到入院时感染发生率的差异。入院时的感染与短期死亡率更高（住院30％比4％，住院30天分别占4％和14％vs 7％），住院时间更长（6天与3天），重症监护病房（28％vs）有关。 18％）和慢性肝功能衰竭（分别为10％和2％）（对于所有患者，p <0.01）。医院感染相对罕见（4％），但在重症监护病房住院的患者中更为常见。抗生素耐药性很常见（38％），但与阴性结果无关。结论我们没有确定感染的人口统计学危险因素，