scholarly journals Assessing the prognosis of cirrhotic patients in the intensive care unit: What we know and what we need to know better

2021 ◽  
Vol 13 (10) ◽  
pp. 1341-1350
Author(s):  
Fernando da Silveira ◽  
Pedro H R Soares ◽  
Luana Q Marchesan ◽  
Roberto S A da Fonseca ◽  
Wagner L Nedel
Author(s):  
Jörg Bojunga ◽  
Mireen Friedrich-Rust ◽  
Alica Kubesch ◽  
Kai Henrik Peiffer ◽  
Hannes Abramowski ◽  
...  

Abstract Background and Aims Liver cirrhosis is a systemic disease that substantially impacts the body’s physiology, especially in advanced stages. Accordingly, the outcome of patients with cirrhosis requiring intensive care treatment is poor. We aimed to analyze the impact of cirrhosis on mortality of intensive care unit (ICU) patients compared to other frequent chronic diseases and conditions. Methods In this retrospective study, patients admitted over three years to the ICU of the Department of Medicine of the University Hospital Frankfurt were included. Patients were matched for age, gender, pre-existing conditions, simplified acute physiology score (SAPS II), and therapeutic intervention scoring system (TISS). Results A total of 567 patients admitted to the ICU were included in the study; 99 (17.5 %) patients had liver cirrhosis. A total of 129 patients were included in the matched cohort for the sensitivity analysis. In-hospital mortality was higher in cirrhotic patients than non-cirrhotic patients (p < 0.0001) in the entire and matched cohort. Liver cirrhosis remained one of the strongest independent predictors of in-hospital mortality (entire cohort p = 0.001; matched cohort p = 0.03) along with dialysis and need for transfusion in the multivariate logistic regression analysis. Furthermore, in the cirrhotic group, the need for kidney replacement therapy (p < 0.001) and blood transfusion (p < 0.001) was significantly higher than in the non-cirrhotic group.  Conclusions In the presented study, liver cirrhosis was one of the strongest predictors of in-hospital mortality in patients needing intensive care treatment along with dialysis and the need for ventilation. Therefore, concerted efforts are needed to improve cirrhotic patients’ outcomes, prevent disease progression, and avoid complications with the need for ICU treatment in the early stages of the disease.


2008 ◽  
Vol 7 (1) ◽  
pp. 78-79 ◽  
Author(s):  
Genaro Vazquez-Elizondo ◽  
Raúl Carrillo-Esper ◽  
Daniel Zamora-Valdés ◽  
Nahum Méndez-Sánchez

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2152 ◽  
Author(s):  
Ming-Hung Tsai ◽  
Hui-Chun Huang ◽  
Yun-Shing Peng ◽  
Yung-Chang Chen ◽  
Ya-Chung Tian ◽  
...  

Malnutrition is associated with adverse outcomes in patients with liver cirrhosis. Relevant data about nutrition risk in critically ill cirrhotic patients are lacking. The modified Nutrition Risk in Critically Ill (mNUTRIC) score is a novel nutrition risk assessment tool specific for intensive care unit (ICU) patients. This retrospective study was conducted to evaluate the prevalence and prognostic significance of nutrition risk in cirrhotic patients with acute gastroesophageal variceal bleeding (GEVB) using mNUTRIC scores computed on admission to the intensive care unit. The major outcome was 6-week mortality. One-hundred-and-thirty-one admissions in 120 patients were analyzed. Thirty-eight percent of cirrhotic patients with acute GEVB were categorized as being at high nutrition risk (a mNUTRIC score of ≥5). There was a significantly progressive increase in mortality associated with the mNUTRIC score (χ2 for trend, p < 0.001). By using the area under a receiver operating characteristic (ROC) curve, the mNUTRIC demonstrated good discriminative power to predict 6-week mortality (AUROC 0.859). In multivariate analysis, the mNUTRIC score was an independent factor associated with 6-week mortality. In conclusion, the mNUTRIC score can serve as a tool to assess nutrition risk in cirrhotic patients with acute GEVB.


2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Delphine Weil ◽  
◽  
Eric Levesque ◽  
Marc McPhail ◽  
Rodrigo Cavallazzi ◽  
...  

Gut ◽  
2012 ◽  
Vol 61 (Suppl 2) ◽  
pp. A199.3-A200 ◽  
Author(s):  
H Lewis ◽  
T Reynolds ◽  
A Lillis ◽  
K Maitland ◽  
G R Foster ◽  
...  

2021 ◽  
Vol 42 (12) ◽  
pp. 1320-1324
Author(s):  
Moayed N. Alkhlewi ◽  
Hasan M. Al-Dorzi ◽  
Farhan Z. Alenezi ◽  
Abdulrahman M. Farhat ◽  
Hani Tamim ◽  
...  

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