Abstract
ABSTRACT
Background & Aims
Liver cirrhosis is associated with an increased risk of bacterial infections, but there is a lack of reliable population‐based data to quantify this risk. We examined the incidence and predictors of community‐acquired serious systemic infections.
Methods
This was a population‐based study that included all patients in the Central Denmark Region diagnosed with alcohol‐related cirrhosis (ALD cirrhosis) in 2013–2022. We computed the cumulative incidence of community‐acquired serious systemic infections, encompassing sepsis and bacteraemia. We used Fine & Gray regression to investigate predictors of infection within the first year.
Results
We included 2511 patients with ALD cirrhosis (69.3% males, median age 61 years, median MELD‐NA score 13). Their cumulative risk of a first‐time community‐acquired serious systemic infection was 3.8% (95% CI: 3.1–4.6) after 1 year and 5.9% (95% CI: 5.0–6.9) after 3 years. The most frequent causative pathogens were Enterobacterales (38%), Staphylococci (25%) and Streptococci (22%). Increasing MELD‐Na score at cirrhosis diagnosis was associated with an increased risk of serious systemic infection within the first year after diagnosis (subdistribution hazard ratio = 1.05, 95% CI: 1.02–1.08, per 1 point increase). The 30‐day all‐cause mortality was 30% (95% CI: 23–37) following hospitalization with a serious systemic infection.
Conclusions
This population‐based study determined the risk and mortality of serious systemic infections in ALD cirrhosis. Our findings will be important for future studies of interventions to prevent infections.