Primary outcome was inpatient mortality. Patient and hospital care variables were analyzed by multivariate, binary logit modeling to identify independent predictors of inpatient mortality. Results: 781,700 adult cirrhotics were admitted to hospitals participating in HCUP from 2002–2010. The number steadily increased by 38% from 72,164 in 2002 to 99,261 in 2010. Inpatient mortality decreased from 8.7% in 2002 to 5.0% in 2010 (p<0.05) while overall
non-cirrhotic inpatient mortality remained constant. However, LY294002 purchase age of cirrhotics increased with 51–60 year-olds having the greatest growth (27% to 37%). Mean Elixhauser Comorbidity Index steadily increased from 2.5 in 2002 to 3.4 in 201 0. The percentage of cirrhotics with decompensation remained steady at 18–20%. Factors independently associated with inpatient death included septicemia (OR 8.7, 8.4–9.1), hepatorenal syndrome (OR 6.3, 95% CI: 6.0–6.7), increased age (61–70 years old, OR 1.9, 1.8–2.0), liver cancer (OR 1.9, 1.8–2.1), and decompensated cirrhosis check details (OR 1.9, 1.8–1.9).
With each year the independent odds of inpatient death declined compared to 2002 (2003: OR 0.93, 0.88–0.99; 2010: OR 0.40, 0.37–0.44). Paracentesis/thora-centesis within 24 hrs was associated with a lower mortality (OR 0.78, 0.74–0.82), while esophagogastroduodenoscopy (EGD) within 24 hrs showed a trend (OR 0.96, 0.91–1.0). Hospital type (teaching/non-teaching; urban/non-urban) was not associated with survival. Summary: Inpatient mortality for cirrhotic patients in the US has steadily fallen by 43% between 2002 and 2010, despite increasing Thymidylate synthase age, comorbidities and stable rates of hepatic decompensation. Sepsis and hepatorenal syndrome are strongly associated with inpatient mortality, but early paracentesis/thoracentesis and EGD are associated with survival. Conclusions: Improved inpatient survival for cirrhotics in the US may be related to better care, including early diagnostic and therapeutic interventions. Disclosures: Monica Schmidt – Grant/Research
Support: Merck & Co.; Patent Held/Filed: HCCplex; Stock Shareholder: PleX Diagnostics Alfred S. Barritt – Grant/Research Support: Salix Pharmaceuticals; Speaking and Teaching: Abbott Molecular The following people have nothing to disclose: Eric S. Orman, Paul H. Hayashi Background: Acetaminophen (APAP), a heavily used over the counter (OTC) and prescribed(Rx) medication; is the leading cause of acute liver failure in the U.S. Prior studies have shown unintentional misuse as well as patient misunderstanding of the risks of concomitant use of APAP products and maximum daily doses. Objective: To evaluate variable labeling and counseling strategies to communicate proper use of APAP-containing products.