scholarly journals Systemic Inflammatory Response Syndrome in Patients Hospitalized for Acute Decompensation of Cirrhosis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ariane Borgonovo ◽  
Caroline Baldin ◽  
Dariana C. Maggi ◽  
Livia Victor ◽  
Emilia T. O. Bansho ◽  
...  

Background. Although recently challenged, systemic inflammatory response syndrome (SIRS) criteria are still commonly used in daily practice to define sepsis. However, several factors in liver cirrhosis may negatively impact its prognostic ability. Goals. To investigate the factors associated with the presence of SIRS, the characteristics of SIRS related to infection, and its prognostic value among patients hospitalized for acute decompensation of cirrhosis. Study. In this cohort study from two tertiary hospitals, 543 patients were followed up, up to 90 days. Data collection, including the prognostic models, was within 48 hours of admission. Results. SIRS was present in 42.7% of the sample and was independently associated with upper gastrointestinal bleeding (UGB), ACLF, infection, and negatively related to beta-blockers. SIRS was associated with mortality in univariate analysis, but not in multiple Cox regression analysis. The Kaplan–Meier survival probability of patients without SIRS was 73.0% and for those with SIRS was 64.7%. The presence of SIRS was not significantly associated with mortality when considering patients with or without infection, separately. Infection in SIRS patients was independently associated with Child-Pugh C and inversely related to UGB. Among subjects with SIRS, mortality was independently related to the presence of infection, ACLF, and Child-Pugh C. Conclusions. SIRS was common in hospitalized patients with cirrhosis and was of no prognostic value, even in the presence of infection.

2020 ◽  
Author(s):  
Min Ju ◽  
Jin Zheng ◽  
li Ying Pan ◽  
lin Lin Gao

Abstract Background:The percutaneous nephrolithotomy (PCNL) is a primary method of stone treatment, but the infection is a very common postoperative complication. The systemic inflammatory response syndrome (SIRS) is a stage of the infection process and a very important early clinical manifestation of sepsis, so identifying the risk factors associated with SIRS after PCNL plays an important role in ensuring patients’ safety and preventing sepsis. Methods:Between September 2016 and September 2017,there were total 352 patients who were diagnosed as renal stone and were treated with PCNL, andincluded in this study at last.Patients were divided into two groups according to whether SIRS occurred or not.The univariate analysis was performed on the related risk factors such as patients' age, gender, number of stone, diabetes et al. Then logistic regression was used for multivariate analysis and established a prediction model.Results:There are 352renal stone patients were treated with PCNL, and 106 patients (30.1%) suffered SIRS after operation.It was found that the operative time, preoperative fever and diabetes could be deemed as risk factors, and the Then logistic regression results indicated that diabetes (OR=2.049, 95%CI 1.008~4.166) and operative time (OR=1.011, 95%CI 1.003~1.019) entered the regression equation.Conclusion: Diabetes and operative time are independent risk factors for SIRS after PCNL, so the probability of SIRS after PCNL can be determined in accordance with these two indicators.


2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 267-267
Author(s):  
Inna Chen ◽  
Christian Dehlendorff ◽  
Benny Vittrup Jensen ◽  
Per Pfeiffer ◽  
Jon K. Bjerregaard ◽  
...  

267 Background: Interleukin-6 (IL-6) and YKL-40 (CHI3L1) are produced by pancreatic cancer (PC) cells and macrophages and activate inflammation. The aim of this prospective-retrospective biomarker study was to determine the prognostic value of serum IL-6 and YKL-40 and systemic inflammatory response in patients with PC receiving palliative chemotherapy. Methods: 625 patients with PC (M/F: 283/342; age <70 vs. ≥70: 395/230; ECOG PS of 0/1/2/3: 214/315/92/4; stage 3 vs. 4: 129/496; treated with gemcitabine n=437, FOLFIRINOX n=117, gemcitabine and nab-Paclitaxel n=54 or other n=17) were included in the BIOPAC biomarker study from 5 hospitals in Denmark. Pretreatment serum values of IL-6 (R&D Systems), YKL-40 (Quidel), and CA 19-9 (Siemens) were determined. Patients were grouped as low vs. high, dichotomized using cut-off for IL-6 > 4.92 pg/ml, for CA19-9 > 2183 U/ml and for YKL-40 > 95% age-corrected percentile. The main outcome was overall survival (OS) and hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were computed using Cox proportional hazards regression. Results: 598 (95.7%) patients died during follow-up. In univariate analysis elevated IL-6 (HR 1.93, 95% CI 1.63-2.28) and elevated YKL-40 (HR 1.74, 95% CI 1.47-2.05) were associated with short OS. Similar results were found if IL-6 and YKL-40 were included as continuous log2-transformed variables. Multivariable analysis showed that elevated IL-6 (HR 1.61, 95% CI 1.33-1.94), elevated YKL-40 (HR 1.36, 95% CI 1.13-1.64), elevated CA19-9 (HR 1.30, 95% CI 1.09-1.56), higher PS (1 vs. 0; HR 1.46, 95% CI 1.21-1.77 and PS 2 vs. 0; HR 2.73, 95% CI 2.08-3.58) and stage 4 vs. 3 (HR 1.79, 95% CI 1.44-2.24) were independently associated with a poor OS. In a subgroup of 386 patients with available laboratory data, higher C-reactive protein (HR 1.20, 95% CI 1.13-1.26), white blood cells (HR 1.41, 1.17-1.71) and absolute neutrophils count (HR 1.35, 95% CI 1.15-1.59) log2-transformed and adjusted for age, sex, PS, CA 19-9 and stage were associated with short OS. Conclusions: Serum IL-6, YKL-40 and CA19-9 along with CRP, WBC and ANC are independent prognostic biomarkers in patients with unresectable PC.


2020 ◽  
Author(s):  
Min Ju ◽  
Jin Zheng ◽  
Lin Lin Gao ◽  
Li Ying Pan

Abstract Background: Percutaneous nephrolithotomy (PCNL) is a primary treatment method for renal stones, but infection is a very common postoperative complication. Systemic inflammatory response syndrome (SIRS) is a stage of the infection process and a very important early clinical manifestation of sepsis, so identifying the risk factors associated with SIRS after PCNL is important for ensuring patient safety and preventing sepsis.Objective: To analyze the risk factors for SIRS after PCNL, identify the predictive factors, and perform risk factor analysis.Methodology: Between September 2016 and September 2017, 352 patients who were diagnosed with renal stones and treated with PCNL were included in this study. The patients were divided into two groups according to whether SIRS occurred. Univariate analysis was performed on the related risk factors, including patient age; gender; body mass index; urine culture; number, types and quantity of rental stones; diabetes; blood glucose; complications; hospital stay; residual stones; and Guy’s degree. Then, logistic regression was used to perform multivariate analysis and establish a predictive model.Results: A total of 352 patients with renal stones were treated with PCNL, and 106 patients (30.1%) developed SIRS after surgery. Operative time, preoperative fever and diabetes were found to be risk factors, and the logistic regression results indicated that diabetes (OR=2.049, 95%CI 1.008~4.166) and operative time (OR=1.011, 95%CI 1.003~1.019) could be entered into the regression equation. Therefore, the predictive regression model was P=1/[1+e-(-2.097+0.712 diabetes + 0.012 operative time)].Conclusion: Diabetes and operative time are independent risk factors for SIRS after PCNL, so the probability of SIRS after PCNL can be determined according to these two indicators.


1995 ◽  
Vol 23 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Robin A. Pixley ◽  
Sharon Zellis ◽  
Patricia Bankes ◽  
Raul A. DeLa Cadena ◽  
Jimmy D. Page ◽  
...  

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