Infections in Hospitalized Cirrhotic Patients

Study Overview
=================
Brief Summary
-----------------
Hospitalized cirrhotic patients are at high risk of complications and adverse outcomes. This study aims to determine the current practice and outcomes in these following areas: Community-acquired infections Nosocomial infections Development of second infections Factors predicting ICU care, organ failure, death, and disability Patterns and adequacy of albumin use in infected and non-infected patients Per and post-liver transplant outcomes Quality-assurance and adequacy of management of complications of cirrhosis such as hepatic encephalopathy, variceal bleeding, hyponatremia, and hypernatremia Regional variations in outcomes and therapeutic strategies

Official Title
-----------------
Infections and Other Complications of Cirrhosis: A Prospective Multi-Center Study

Conditions
-----------------
Cirrhosis

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Male and Female over 18 years of age Cirrhosis as diagnosed by either liver histology or a combination of clinical biochemical (low platelets, elevated bilirubin, and/or INR, low albumin) radiologic (nodular liver on ultrasound) and endoscopic (esophageal varices) criteria Subject must be able to understand and provide informed consent Evaluated in the ER or admitted to the hospital for non-elective reasons Exclusion Criteria: admitted for elective purpose

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency, Cause and Outcome of Community-acquired infections | Collecting details of infections including type, organism, antibiotic used, length of stay, ICU stay and outcomes | From admission to 1 year post-discharge from the hospital | 
| Frequency, Cause, and Outcome of Nosocomial infections | Collecting details of infections including type, organism, antibiotic used, length of stay, ICU stay and outcomes | From admission to 1 year post-discharge from the hospital | 
| Development of second infections | Distinctly different from primary infection | From admission to 1 year post-discharge from the hospital | 
| Factors predicting ICU care, organ failure, death, and disability | Admission to the ICU and events/outcomes of that subject's admission | From admission to 1 year post-discharge from the hospital | 
| Patterns and adequacy of albumin use in infected and non-infected patients | IV albumin administration | From admission to 1 year post-discharge from the hospital | 
| Quality-assurance and adequacy of management of complications of cirrhosis such as hepatic encephalopathy, variceal bleeding, hyponatremia, and hypernatremia | Blood test and other obvious clinical evidence of decompensation | From admission to 1 year post-discharge from the hospital | 
| Peri and post-liver transplant outcomes based on physiological parameters | Collection of liver transplant donor and recipient information such as blood group, CMV status, post-transplant infections, immunosuppression regimen, and prophylaxis given. | From admission to 1 year post-discharge from the hospital | 
| Regional variations in outcomes and therapeutic strategies | Comparison of data between sites conducting this study across the United States and Canada | From admission to 1 year post-discharge from the hospital |