Coagulopathy and Hospital Outcomes in Patients With Spontaneous Bacterial Peritonitis: A Call for Action to Improve Care of Inpatients

Abstract

To assess the risk of in-hospital mortality in spontaneous bacterial peritonitis (SBP) with coagulopathy, and to understand the impact of comorbid coagulopathy on length of stay (LOS) and total charges for SBP inpatients. Methods We included adult patients (age, 18-50 years) with a principal diagnosis of SBP using the Nationwide Inpatient Sample (NIS, 2012 to 2014). These patients were further subgrouped by comorbid coagulopathy. The independent sample t-test was used to measure the mean difference in LOS and total charges between subgroups. The logistic regression model was used to measure the odds ratio (OR) of association of coagulopathy and in-hospital mortality after adjusting for demographic confounders and other comorbid risk factors. Results SBP with comorbid coagulopathy was prevalent in males (68.7%) and white (58.1%). When compared with the non-coagulopathy cohort, males had 1.6 times (95% CI 1.46-1.84), and hispanics had 1.4 times (95% CI 1.19-1.58) high odds for coagulopathy. In-hospital mortality was statistically significant in SBP inpatients with coagulopathy (6.5% vs. 2.8% in noncoagulopathy), and with two times higher odds of association (95% CI 1.47-2.51) compared with non-coagulopathy cohort. SBP inpatients with comorbid coagulopathy had a statistically significantly higher LOS by 1.1 days and higher total charges by $14,123 per hospitalization compared with the non-coagulopathy cohort. Conclusions Coagulopathy is a significant risk factor that increases the risk of in-hospital mortality in SBP inpatients by 92%. Comorbid coagulopathy is also associated with extended LOS and higher hospitalization costs, thereby increasing the healthcare burden. Clinicians need to effectively manage coagulopathy in SBP patients to improve patient outcomes and reduce the healthcare burden with better health-related quality of life.

Coagulopathy associated with COVID-19 – Perspectives & Preventive strategies using a biological response modifier Glucan

“…However, with the disease having affected Caucasian individuals at a magnitude several times greater than it has affected Chinese individuals, it is essential to know the ethnicity-related risk of thrombogenic events. Caucasians have higher thrombotic risk than Chinese and other Asian populations, and the risk is even higher in African-American and Hispanic patients in the USA [ 27 – 29 ]. Consistent with this pattern, a study conducted on COVID-19 coagulopathy in Caucasian patients showed that although the risk of coagulopathy was higher in Caucasians, because the patients included in the study were on low-molecular-weight heparin (LMWH) thromboprophylaxis, they rarely developed overt DIC, and in cases where DIC developed, it was during the later stages of the disease only.…”