BACKGROUND/AIMS: Some evidence suggests that the systemic inflammatory response syndrome (SIRS) contributes to the poor outcome of cirrhotic patients. We studied 141 cirrhotic patients consecutively admitted to a tertiary referral centre assessing prevalence of SIRS and its relationship with in-hospital outcome. METHODS: Presence of SIRS was assessed on admission and during hospital stay. Main clinical outcomes were death and development of portal hypertension-related complications. RESULTS: Thirty-nine patients met SIRS criteria. SIRS was present on admission in 20 of 141 patients (14.1%), whereas it occurred during hospital stay in 19 of 121 (15.7%). SIRS was correlated with bacterial infection at admission (p=0.02), jaundice (p=0.011), high serum creatinine levels (p=0.04), high serum bilirubin levels (p=0.002), high international normalized ratio (p=0.046), high model of end-stage liver disease (MELD) score (p=0.001), and high SOFA score (p=0.003). During a follow-up of 14+/-8 days, 16 patients died (11%), 7 developed portal hypertension-related bleeding (5%), 16 hepatic encephalopathy (11%), and 5 hepatorenal syndrome type-1 (3.5%). SIRS was correlated both to death (p<0.001) and to portal hypertension-related complications (p<0.001). On multivariate analysis, SIRS and MELD were independently associated with death. CONCLUSIONS: SIRS frequently occurs in patients with advanced cirrhosis and is associated with a poor outcome.
BACKGROUND/AIMS: Some evidence suggests that the systemic inflammatory response syndrome (SIRS) contributes to the poor outcome of cirrhoticpatients. We studied 141 cirrhoticpatients consecutively admitted to a tertiary referral centre assessing prevalence of SIRS and its relationship with in-hospital outcome. METHODS: Presence of SIRS was assessed on admission and during hospital stay. Main clinical outcomes were death and development of portal hypertension-related complications. RESULTS: Thirty-nine patients met SIRS criteria. SIRS was present on admission in 20 of 141 patients (14.1%), whereas it occurred during hospital stay in 19 of 121 (15.7%). SIRS was correlated with bacterial infection at admission (p=0.02), jaundice (p=0.011), high serum creatinine levels (p=0.04), high serum bilirubin levels (p=0.002), high international normalized ratio (p=0.046), high model of end-stage liver disease (MELD) score (p=0.001), and high SOFA score (p=0.003). During a follow-up of 14+/-8 days, 16 patients died (11%), 7 developed portal hypertension-related bleeding (5%), 16 hepatic encephalopathy (11%), and 5 hepatorenal syndrome type-1 (3.5%). SIRS was correlated both to death (p<0.001) and to portal hypertension-related complications (p<0.001). On multivariate analysis, SIRS and MELD were independently associated with death. CONCLUSIONS: SIRS frequently occurs in patients with advanced cirrhosis and is associated with a poor outcome.
Authors: Florence Wong; Jacqueline G O'Leary; K Rajender Reddy; Heather Patton; Patrick S Kamath; Michael B Fallon; Guadalupe Garcia-Tsao; Ram M Subramanian; Raza Malik; Benedict Maliakkal; Leroy R Thacker; Jasmohan S Bajaj Journal: Gastroenterology Date: 2013-08-30 Impact factor: 22.682
Authors: Hyun Park; Ki Jun Jang; Won Jang; Sang Hoon Park; Ji Young Park; Tae Joo Jeon; Tae Hoon Oh; Won Chang Shin; Won-Choong Choi; Dong Hyun Sinn Journal: World J Gastroenterol Date: 2015-03-28 Impact factor: 5.742
Authors: Jasmohan S Bajaj; Jacqueline G O'Leary; K Rajender Reddy; Florence Wong; Jody C Olson; Ram M Subramanian; Geri Brown; Nicole A Noble; Leroy R Thacker; Patrick S Kamath Journal: Hepatology Date: 2012-12 Impact factor: 17.425