{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T05:01:39Z","timestamp":1785042099257,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) are reported to have an increased risk of developing severe infections, leading to hospitalizations with sepsis. However, data regarding the impact of comorbid NAFLD on in-hospital outcomes of patients with sepsis is scarce. Methods: This nationwide retrospective observational study using discharge data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), and Agency for Healthcare Research and Quality included 21,057,911 adult patients who were admitted to hospitals in the United States between 2000 and 2019 with a primary discharge diagnosis of sepsis. These patients were categorized according to the presence or absence of comorbid NAFLD. The twenty-year trend of nationwide NAFLD prevalence among sepsis inpatients was elucidated. Multivariable logistic regression analysis was used to analyze NAFLD\u2019s impact on sepsis outcomes. Results: In the twenty-year study period, the prevalence of NALFD among sepsis inpatients trended up from 1.2% in 2000 to 4.2% in 2019. Similar trends were observed in regional analysis. While overall sepsis mortality decreased, comorbid NAFLD in sepsis patients was consistently associated with a higher adjusted in-hospital all-cause mortality rate (adjusted odds ratio (OR), 1.19; 95% confidence interval (CI), 1.07\u20131.32), higher odds of developing septic shock, and higher likelihood of development of multi\u2013organ dysfunction. Conclusions: Comorbid NAFLD in the stage of NASH or cirrhosis is associated with higher in-hospital all-cause mortality and worse clinical outcomes in sepsis inpatients. Addressing this rising epidemic will be of paramount importance to improve sepsis in-hospital outcomes.<\/jats:p>","DOI":"10.3390\/jcm13195737","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T08:20:52Z","timestamp":1727338852000},"page":"5737","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Non-Alcoholic Fatty Liver Disease on Sepsis Inpatient Outcomes: A Nationwide Sample Analysis (2000\u20132019)"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4177-6597","authenticated-orcid":false,"given":"Xiuhong","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, USA"},{"name":"Department of Adult Medicine, Brockton Neighborhood Health Center, 63 Main Street, Brockton, MA 02301, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hospital Internal Medicine, Mayo Clinic Health System, 1025 Marsh Street, Mankato, MN 56001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiting","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of New\u2013Mexico Health Science Center, 2500 Marble Ave., Albuquerque, NM 87106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichen","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, The Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Miskovsky","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Roger Williams Medical Center, 825 Chalkstone Ave., Providence, RI 02908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Gaitanis","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Providence VA Medical Center, 830 Chalkstone Ave., Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittichai","family":"Promrat","sequence":"additional","affiliation":[{"name":"Providence VA Medical Center, Section of Gastroenterology, 830 Chalkstone Ave., Providence, RI 02908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2834-2024","authenticated-orcid":false,"given":"Wen-Chih","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Warren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI 02903, USA"},{"name":"Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA"},{"name":"Center of Innovation for Long Term Services & Support, Veterans Affairs Medical Center, 830 Chalkstone Ave., Providence, RI 02908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3350\/cmh.2022.0365","article-title":"Global incidence and prevalence of nonalcoholic fatty liver disease","volume":"29","author":"Teng","year":"2023","journal-title":"Clin. 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