@article{ref1,
title="Deleterious Effect of Cirrhosis on Outcomes After Motor Vehicle Crashes Using the Nationwide Inpatient Sample",
journal="American journal of gastroenterology",
year="2008",
author="Bajaj, Jasmohan S. and Ananthakrishnan, Ashwin N. and McGinley, Emily L. and Hoffmann, Raymond G. and Brasel, Karen J.",
volume="103",
number="7",
pages="1674–1681-1674–1681",
abstract="OBJECTIVES: 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. METHODS: NIS 2004 was queried for cirrhotics with MVC (C-MVC), cirrhotics only, and MVC only for demographics, comorbidities, hospital characteristics, and the Injury Severity Score (ISS). C-MVC patients were compared with the other groups. Weighted uni/multivariate regression was performed for all MVCs (with/without cirrhosis). RESULTS: 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<0.0005) and had less comorbidities than cirrhosis only, but had similar mortality (C-MVC 10.8%vs cirrhosis only 9.9%, P=0.23). C-MVC patients (49.8 yr) were older than MVC only patients (43.7 yr, P<0.0005). C-MVC patients also had significantly higher mortality (10.8%) compared with MVC only (3.1%, P<0.0005) despite similar ISS. C-MVC patients had significantly greater LOS (9.6 days) and charges ($67,119) compared with both MVC only (6.2 days, $43,314) and cirrhosis only (7.4 days, $35,522). Cirrhosis (odds ratio [OR] 3.5, 95% confidence interval [CI] 2.5-5.5) and age /> 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. CONCLUSION: Cirrhosis is associated with greater mortality, LOS, and charges after MVC despite controlling for injury severity, comorbidities, and age in NIS 2004.  <p>Language: en</p>",
language="en",
issn="0002-9270",
doi="10.1111/j.1572-0241.2008.01814.x",
url="http://dx.doi.org/10.1111/j.1572-0241.2008.01814.x"
}