Prevalence and in-hospital outcomes of diabetes mellitus in elderly patients with liver cirrhosis

Huixian Han, Yanli Sun, Yongguo Zhang, Frank Tacke, Haitao Zhao, Han Deng, Feifei Hou, Ran Wang, Yasuhiko Sugawara, Andrea Mancuso, Xingshun Qi, Written on behalf of the AME Liver Disease Group


Background: A retrospective, single-center, observational study aimed to evaluate the prevalence and in-hospital outcomes of diabetes mellitus (DM) in elderly patients with liver cirrhosis.
Methods: All electronic records of consecutive patients diagnosed with liver cirrhosis without malignancy at our hospital from January 2012 to June 2014 were retrospectively collected. Patient cohorts were subdivided according to age (elderly: above 60 years), presence of DM and glycemic control of DM patients (HbA1c >7%), patient characteristics, liver cirrhosis complications and in-hospital mortality were assessed.
Results: Overall, 36.9% (452/1,225) of cirrhotic patients were elderly, and 20.6% (252/1,225) of them had DM. Elderly patients had a significantly higher percentage of DM than non-elderly patients [25.9% (117/452) versus 17.5% (135/773), P=0.001]. Elderly patients with DM had a significantly higher in-hospital mortality than those without DM [8.5% (10/117) versus 1.8% (6/335), P=0.002], but Child-Pugh and MELD scores were similar between them. Additionally, good diabetic control was significantly associated with a lower Child-Pugh score, but not in-hospital mortality.
Conclusion: DM is more common in elderly patients with liver cirrhosis. DM may increase the in-hospital mortality in such patients, independent from the stage of cirrhosis.