Prognostic markers in cirrhotic patients requiring intensive care: a comparative prospective study
Journal Title: Annals of Hepatology - Year 2012, Vol 11, Issue 4
Abstract
Introduction. The use of prognostic models for cirrhotic patients admitted to the medical intensive care unit (ICU) is of great importance, since they provide an objective evaluation for a group of patients with high mortality rates and high resource utilization. Objective. To evaluate the validity and to compare theprognostic predictive value of the CTP, MELD, SOFA and APACHE II scoring systems in cirrhotic patients admitted to the ICU, the CTP and MELD models being exclusive for patients with liver disease. Material and methods. Commonly used predictors of mortality such as age, sex, CTP, MELD, APACHE II and SOFA were evaluated, and their prognostic value was investigated. Results. A total of 201 patients were included in this study. Patients who survived had mean CTP score of 9.5 ± 2.4, MELD score 18.1 ± 7.1, APACHE II score of 13.4 ± 4.8 and SOFA score of 4.2 ± 2.6, compared to respective scores of 11.4 ± 2.8, 28.0 ± 11.2, 24.6 ± 10.4 and 8.7 ± 4.0 in patients who died. The difference between groups was statistically significant for each of one of the scoring systems (p < 0.001). Conclusion. In this study, SOFA was found to be the mostpowerful predictor of prognosis for cirrhotic patients admitted to the ICU. This was followed by APACHE II, MELD and CTP models, in descending order of strength (AUROC values of 0.847, 0.821, 0.790 and 0.724, respectively).
Authors and Affiliations
Sehmus Ölmez, Yüksel Gümürdülü, Adnan Tas, Emre Karakoc, Banu Kara, Adem Kidik
Keywords
Related Articles
- EP ID EP78169
- DOI -
- Views 117
- Downloads 0
Response to different therapeutic approaches in Wilson disease. A long-term follow up study
Background and aims. There are certain areas of uncertainty regarding the best therapeutic approach in patients diagnosed with Wilson Disease (WD). Our aim was to assess treatment response to different therapies in a coh...
Nutritional support in the treatment of chronic hepatic encephalopathy
The prevalence of under nutrition in cirrhotic patients is 61% and it usually progresses as the disease becomes more advanced. The deterioration in the nutritional status and its associated metabolic derangements has rai...
Antiviral therapy in patients with HCV-cirrhosis
The main cause of liver cirrhosis and liver cancer in the western world is Hepatitis C virus (HCV) infection. Liver transplantation is the only effective treatment once the disease is decompensated. In viremic patients w...
Occult HBV infection among anti-HBc positive HIV-infected patients in apex referral centre, Eastern India
Background. The prevalence of occult HBV, defined by the presence of HBV DNA in individuals with antibodies to HBV core antigen and with absence of HBV surface antigen, but its clinical significance and virological fea...
Association of plasma visfatin with hepatic and systemicinflammation in nonalcoholic fatty liver disease
Background. Visfatin is a proinflammatory and insulin-mimetic adipokine contributing to whole body glucose and lipid metabolism. Studies to date are conflicting regarding the relationship between visfatin and non-alcohol...