Hypoglycemia is Associated with Increased In-Hospital Mortality in Patients with Liver Cirrhosis; A Nationwide Study

AimCirrhosis may cause dysregulation of glucose homeostasis due to abnormalities in metabolism and responses to changes in the blood glucose level.Cirrhotic patients may be more prone to hypoglycemia.Hypoglycemia is associated with poor outcomes in cirrhotic patients with sepsis and may indicate a greater severity of illness.This study aims to elucidate the effect of hypoglycemia on in-hospital mortality in cirrhotic patients. MethodsThis review was completed using the National Inpatient Sample (NIS) database from 2016 to 2019.Using ICD-10-CM codes, we identi ed patients carrying a diagnosis of cirrhosis and hypoglycemia and gathered baseline demographic and clinical data.Odds ratios (OR) for comorbidities were calculated.Diabetic patients were excluded from the study to rule out the possibility of iatrogenic hypoglycemia. ResultsOut of 1,778,829 inpatients with cirrhosis, 31,615 had a diagnosis of hypoglycemia.Total hospital charges were signi cantly higher in the cirrhosis and hypoglycemia group compared to the nonhypoglycemia group.The mean length of stay (LOS) in the hypoglycemia group was signi cantly higher.Mortality, vasopressor usage, mechanical ventilation, cardiac arrest, and intensive care unit (ICU) admission were signi cantly higher in the hypoglycemia group compared to the non-hypoglycemia one. ConclusionIn patients with cirrhosis, hypoglycemia was associated with higher in-hospital mortality and rate of critical illness as suggested by elevated rates of ICU admission, mechanical ventilation, and vasopressor use.These patients also had longer hospital LOS and higher total hospital charges.Hypoglycemia may re ect advanced liver disease or indicate early sepsis and potentially forbodes a prolonged, complicated hospital course.