scholarly journals Applicability of the Chronic Liver Failure-Consortium score in patients with cirrhosis and bacterial infections: a single-clinic experience

2021 ◽  
Vol 55 (4) ◽  
pp. 239-245
Author(s):  
D.I. Haurylenka ◽  
N.N. Silivontchik
Keyword(s):  
Liver Failure ◽  
Bacterial Infections ◽  
Serum Bilirubin Level ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Acute Decompensation ◽  
Clinic Experience ◽  
Cirrhotic Patients ◽  
The City ◽  
Number Needed To Harm

Background. The frequency and characteristics of acute-on-chronic liver failure (ACLF) are reported in numerous articles from different countries. The aim of the study was to assess the cirrhosis decompensation in patients with bacterial infections based on the Chronic Liver Failure-Consortium (CLIF-C) score in one of the city clinics in Belarus. Materials and methods. The patients underwent laboratory and instrumental studies during the hospitalization. The assessment of the syndrome of acute-on-chronic liver failure was performed using the CLIF-C score. Bacterial infections were diagnosed on the basis of standard criteria. Results. The study included 151 cirrhotic patients, 87 males and 64 females. Median age was 55 years (Q1 = 43; Q3 = 61). Cirrhosis was predominantly due to alcohol addiction — 83 patients (55 %). ACLF was diagnosed in 44 of 151 patients with cirrhosis (29.1 %; 95% confidence interval (CI) 22.0–37.1). Bacterial infections were detected in 67 people (44.4 %; 95% CI 36.3–52.7). Most often patients had liver failure that was detected by an increase in serum bilirubin level. Among individuals with upper gastrointestinal bleedings, number needed to harm for developing ACLF was 3.3 (95% CI 2.2–4.4). The risk of developing ACLF grade 2 and 3 in cirrhotic patients with infections was 8.2, with 95% CI 1.0–69.6 (number needed to harm was 12.9; 95% CI 10.7–15.0). Bacterial infections increase the risk of acute decompensation in patients with cirrhosis (odds ratio = 2.0, p = 0.048). Conclusions. The CLIF-C score is quite applicable in our cohort of patients with cirrhosis.

scholarly journals The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure

2015 ◽  
Vol 62 (4) ◽  
pp. 831-840 ◽  
Author(s):  
Rajiv Jalan ◽  
Marco Pavesi ◽  
Faouzi Saliba ◽  
Alex Amorós ◽  
Javier Fernandez ◽  
...  
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Acute Decompensation ◽  
Cirrhotic Patients

Assessment of Sepsis-3 criteria and quick SOFA in patients with cirrhosis and bacterial infections

Gut ◽  
2017 ◽  
Vol 67 (10) ◽  
pp. 1892-1899 ◽  
Author(s):  
Salvatore Piano ◽  
Michele Bartoletti ◽  
Marta Tonon ◽  
Maurizio Baldassarre ◽  
Giada Chies ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Liver Failure ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Chronic Liver ◽  
Population Increase ◽  
Chronic Liver Failure ◽  
Reactive Protein ◽  
Acute Decompensation ◽  
Sirs Criteria

IntroductionPatients with cirrhosis have a high risk of sepsis, which confers a poor prognosis. The systemic inflammatory response syndrome (SIRS) criteria have several limitations in cirrhosis. Recently, new criteria for sepsis (Sepsis-3) have been suggested in the general population (increase of Sequential Organ Failure Assessment (SOFA) ≥2 points from baseline). Outside the intensive care unit (ICU), the quick SOFA (qSOFA (at least two among alteration in mental status, systolic blood pressure ≤100 mm Hg or respiratory rate ≥22/min)) was suggested to screen for sepsis. These criteria have never been evaluated in patients with cirrhosis. The aim of the study was to assess the ability of Sepsis-3 criteria in predicting in-hospital mortality in patients with cirrhosis and bacterial/fungal infections.Methods259 consecutive patients with cirrhosis and bacterial/fungal infections were prospectively included. Demographic, laboratory and microbiological data were collected at diagnosis of infection. Baseline SOFA was assessed using preadmission data. Patients were followed up until death, liver transplantation or discharge. Findings were externally validated (197 patients).ResultsSepsis-3 and qSOFA had significantly greater discrimination for in-hospital mortality (area under the receiver operating characteristic (AUROC)=0.784 and 0.732, respectively) than SIRS (AUROC=0.606) (p<0.01 for both). Similar results were observed in the validation cohort. Sepsis-3 (subdistribution HR (sHR)=5.47; p=0.006), qSOFA (sHR=1.99; p=0.020), Chronic Liver Failure Consortium Acute Decompensation score (sHR=1.05; p=0.001) and C reactive protein (sHR=1.01;p=0.034) were found to be independent predictors of in-hospital mortality. Patients with Sepsis-3 had higher incidence of acute-on-chronic liver failure, septic shock and transfer to ICU than those without Sepsis-3.ConclusionsSepsis-3 criteria are more accurate than SIRS criteria in predicting the severity of infections in patients with cirrhosis. qSOFA is a useful bedside tool to assess risk for worse outcomes in these patients. Patients with Sepsis-3 and positive qSOFA deserve more intensive management and strict surveillance.

scholarly journals Chronic liver failure-consortium acute-on-chronic liver failure and acute decompensation scores predict mortality in Brazilian cirrhotic patients

2017 ◽  
Vol 23 (28) ◽  
pp. 5237 ◽  
Author(s):  
Rafael Veiga Picon ◽  
Franciele Sabadin Bertol ◽  
Cristiane Valle Tovo ◽  
Ângelo Zambam de Mattos
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Acute Decompensation ◽  
Cirrhotic Patients

scholarly journals Prevalence and Risk Factors of Acute-on-Chronic Liver Failure at SanglahGeneral Hospital Denpasar Bali

2021 ◽  
Vol 14 (1) ◽  
pp. 235-239
Author(s):  
Cokorda Agung Wahyu Purnamasidhi ◽  
I Ketut Mariadi ◽  
I Dewa Nyoman Wibawa
Keyword(s):  
Risk Factors ◽  
Liver Failure ◽  
Death Rate ◽  
Bacterial Infections ◽  
Causes Of Death ◽  
Chronic Liver ◽  
Clinical Feature ◽  
Chronic Liver Failure ◽  
Triggering Factor ◽  
Cirrhotic Patients

Background: Acute-on-chronic liver failure(ACLF) has been acknowledged as the suddenworsening of liver capacity in cirrhotic patients, which is typicallylinkedto a triggering factor and results in the collapse of at least one organ. ACLF has been known to be a highly mortal case. The reason for this investigation was to decide the incidence, features, risk factors and death at 30 days of individuals with ACLF. Method: The present study was conducted in Sanglah general hospital, included an amount of 110 cirrhotic patients whom admitted for hospitalizationamid the period of June 2016 and July 2017. ACLF diagnostic criteria by the European Association for the Study of the Liver-Chronic Liver Failure-Consortium was utilized. Our population was separated into the ACLF and non-ACLF group. Clinical feature, triggering occasions, possible risk factors for promoting ACLF and explanation for death were figured out. Mortality and causes of death at 30 days was assessed regarding the matter. Thirty-days mortality of the subjects was assessed. Results: Nine patients (8.2%) established ACLF. Bacterial infections were perceived as antriggering eventof 100% of cases ACLF with Pneumonia (44.4%) and Peritonitis (33.3%) as a center contamination. Contrasting the ACLF and non-ACLF group, statistically important features were: existence of hepatic encephalopathy in 9 (100%)vs30 (29.7%) (P < 0.01), leukocytosis of 19.34±1.97 x109vs7.74±3.93 x109 (P < 0.01) and nearness of ascites amid hospitalization 9 (100%) vs43 (42,5%)(P = 0.001). Death rate was 100% (9 patients) vs6.9% (7 patients), individually (P < 0.01). Conclusion: Our present study concluded that ACLF had a high mortality rate with noteworthyrisk factors are liver encephalopathy, leukocytosis and ascites.

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