University of California Riverside School of Medicine Rancho Cucamonga, CA
Khaled Al Smadi, MD1, Muhammad Shikaib. Shabbir, MD2, Ashujot Dang, MD3, Miguel Salazar, MD4, Gianina Flocco, MD5, Donghyun Ko, MD6, Do Han Kim, MD, MSc7, Pedro Palacios Argueta, MD8, Zeid Kayali, MD4 1University of California Riverside School of Medicine, Rancho Cucamonga, CA; 2University of California Riverside School of Medicine, San Bernardino, CA; 3University of California Riverside School of Medicine, Redlands, CA; 4University of California Riverside School of Medicine, Rialto, CA; 5Cleveland Clinic, Fairview Park, OH; 6Bridgeport Hospital, Bridgeport, CT; 7Icahn School of Medicine at Mount Sinai, New York, NY; 8Thomas Jefferson University Hospital, Philadelphia, PA Introduction: Hepatic congestion and/or liver hypoperfusion in the setting of heart failure leads to ischemic hepatitis (IH). Accordingly, evaluating the impact of ischemic hepatitis as a potential predictor of heart failure outcomes would provide a better understanding of both diseases. Methods: The National Inpatient Sample (NIS) from 2016 to 2020 was retrospectively queried using ICD-10CM/PCS codes to identify patients discharged with a diagnosis of CHF and concomitant IH. Primary outcome was in-hospital mortality. Secondary outcomes included rate of post-procedural complications such as acute kidney injury (AKI), shock, encephalopathy, and sepsis. Length of stay (LOS), total hospital charges and hospital cost were calculated. Kaplan Mier analysis was conducted to compare survival between the two groups. Moreover, multivariate logistic regression analysis was performed to adjust for potential confounders. Results: A total of 1,372,419 patients were included in the analysis. Patients were categorized into two groups based on the presence of IH. Among these patients, 36839 (2.7%) were identified to have IH. These patients were less likely to be females (41.3% Vs. 47.9%; p< 0.01), and less likely to be White (63.5% Vs. 68%; p< 0.01). Mean age of diagnosis was lower among those with ischemic hepatitis (66.7 Vs. 70.5; p< 0.01) which explains the predominance of Medicare insurance in both groups (59.4% and 70.3%; p< 0.01). However, those without ischemic hepatitis had higher comorbidity rates including type 2 DM (40.2% Vs. 30.4%; p< 0.01), CKD stage V (6.1% Vs. 4.5%; p< 0.01) and BMI > 40 (11.2% Vs. 6.6%; p< 0.01).
Kaplan Mier survival analysis did not show a significantly higher mortality between the two groups during hospitalization. Among patients with IH, predictors of mortality were SIRS (4.49; p< 0.01), sepsis (2.41; p< 0.01), AKI (3.65; p< 0.01), CKD V (1.89; p< 0.01), ascites (1.89; p< 0.01), cirrhosis (1.18; p< 0.01), age 40-64 (1.55; p< 0.01), age over 65 (2.90; p< 0.01).
On multivariate analysis, there was no significant difference in in-hospital mortality (aOR 0.96; p=0.1) or in the length of stay (5.36; p=0.34). However, patients with IH had higher odds of ICU admissions aOR 1.42; p< 0.01), shock (aOR 1.41; p<0.01)), AKI (aOR 1.42; p<0.01) and pleural effusion (aOR 1.40; p< 0.01). Discussion: Ischemic hepatitis in patients with congestive heart failure is associated with higher in-hospital complications however in-hospital mortality and length of stay were not significantly different.
Figure: Table. Adjusted Predictors of In-hospital Mortality
Figure: Figure. Kaplan-Meir Curve for In-hospital Survival
Disclosures: Khaled Al Smadi indicated no relevant financial relationships. Muhammad Shabbir indicated no relevant financial relationships. Ashujot Dang indicated no relevant financial relationships. Miguel Salazar indicated no relevant financial relationships. Gianina Flocco indicated no relevant financial relationships. Donghyun Ko indicated no relevant financial relationships. Do Han Kim indicated no relevant financial relationships. Pedro Palacios Argueta indicated no relevant financial relationships. Zeid Kayali indicated no relevant financial relationships.
Khaled Al Smadi, MD1, Muhammad Shikaib. Shabbir, MD2, Ashujot Dang, MD3, Miguel Salazar, MD4, Gianina Flocco, MD5, Donghyun Ko, MD6, Do Han Kim, MD, MSc7, Pedro Palacios Argueta, MD8, Zeid Kayali, MD4. P5873 - The Impact of Ischemic Hepatitis on Outcomes and Healthcare Resources Utilization in Patients With Congestive Heart Failure, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
