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Thursday, July 31, 2008

Deleterious Effect of Cirrhosis on Outcomes After Motor Vehicle Crashes Using the Nationwide Inpatient Sample
Am J Gastroenterol 2008;103:1674–1681

Alcohol abuse and minimal hepatic encephalopathy may predispose cirrhotics to a higher motor vehicle crash (MVC) rate. Cirrhotics have poor post-trauma outcomes on small-scale studies.

The aim was to examine the effect of cirrhosis on mortality, charges, and length of stay (LOS) after MVCs using the Nationwide Inpatient Sample (NIS) 2004.

There were 560,080 discharges for cirrhosis only, 262,244 for MVC only, and 1,565 for C-MVC. C-MVC patients were significantly younger (49.8 yr vs 58.6 yr, P <>vs cirrhosis only 9.9%, P = 0.23). C-MVC patients (49.8 yr) were older than MVC only patients (43.7 yr, P <>P <>65 yr (OR 5.2, 95% CI 4.4–6.0) were most commonly associated with mortality. Male sex, high ISS, self-pay, teaching, and large and urban hospitals were also significantly associated with mortality. On multivariate regression, cirrhosis was associated with greater charges and LOS.

Cirrhosis is associated with greater mortality, LOS, and charges after MVC despite controlling for injury severity, comorbidities, and age in NIS 2004.

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