Details

Autor(en) / Beteiligte

• Pan, H.‐C.
• Jenq, C.‐C.
• Tsai, M.‐H.
• Fan, P.‐C.
• Chang, C.‐H.
• Chang, M.‐Y.
• Tian, Y.‐C.
• Hung, C.‐C.
• Fang, J.‐T.
• Yang, C.‐W.
• Chen, Y.‐C.

Titel

Scoring systems for 6‐month mortality in critically ill cirrhotic patients: a prospective analysis of chronic liver failure – sequential organ failure assessment score (CLIF‐SOFA)

Ist Teil von

• Alimentary pharmacology & therapeutics, 2014-11, Vol.40 (9), p.1056-1065

Ort / Verlag

Oxford: Blackwell

Erscheinungsjahr

2014

Link zum Volltext

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Summary Background Cirrhotic patients admitted to intensive care units (ICUs) have high mortality rates. The Chronic Liver Failure–Sequential Organ Failure Assessment (CLIF‐SOFA) score, a modified Sequential Organ Failure Assessment (SOFA) score, is a newly developed scoring system exclusively for patients with end‐stage liver disease. Aim To externally validate the efficacy of the CLIF‐SOFA score and evaluate other scoring systems for 6‐month mortality in critically ill cirrhotic patients. Methods This study prospectively recorded and analysed the data for 30 demographical parameters and some clinical characteristic variables on day 1 of 250 cirrhotic patients admitted to a 10‐bed specialised hepatogastroenterology ICU in a 2000‐bed tertiary care referral hospital during the period from September 2010 to August 2013. Results The overall in‐hospital and 6‐month mortality rate were 58.8% (147/250) and 78.0% (195/250), respectively. Liver diseases were mostly attributed to hepatitis B virus infection (32%). Multiple Cox logistic regression hazard analysis revealed that Glasgow coma scale, both the CLIF‐SOFA and Acute Physiology and Chronic Health Evaluation III (ACPACHE III) scores determined on the first day of ICU admission were independent predictors of 6‐month mortality. Analysis of the area under the receiver operating characteristic curve revealed that the CLIF‐SOFA score had the best discriminatory power (0.900 ± 0.020). Moreover, the cumulative 6‐month survival rates differed significantly for patients with a CLIF‐SOFA score ≤11 and those with a CLIF‐SOFA score >11 on the ICU admission day. Conclusion Both CLIF‐SOFA and APACHE III scores are excellent prognosis evaluation tools for critically ill cirrhotic patients.