Benoît Dupont1, Maxime Delvincourt2, Mamadou Koné3, Damien du Cheyron4, Isabelle Ollivier-Hourmand5, Marie-Astrid Piquet6, Nicolas Terzi7, Thông Dao8. 1. Caen University Hospital, Department of Hepato-Gastroenterology and Nutrition, Caen, France. Electronic address: benoit-dupont@outlook.com. 2. Caen University Hospital, Department of Hepato-Gastroenterology and Nutrition, Caen, France. Electronic address: mdelvincourt@gmail.com. 3. Caen University Hospital, Department of Biostatistics and Clinical Research, Caen, France. Electronic address: mamadou.kone@upmc.fr. 4. Caen University Hospital, Medical Intensive Care, Caen, France. Electronic address: ducheyron-d@chu-caen.fr. 5. Caen University Hospital, Department of Hepato-Gastroenterology and Nutrition, Caen, France. Electronic address: ollivierhourmand-i@chu-caen.fr. 6. Caen University Hospital, Department of Hepato-Gastroenterology and Nutrition, Caen, France. Electronic address: piquet-ma@chu-caen.fr. 7. Caen University Hospital, Medical Intensive Care, Caen, France. Electronic address: terzi-n@chu-caen.fr. 8. Caen University Hospital, Department of Hepato-Gastroenterology and Nutrition, Caen, France. Electronic address: dao-t@chu-caen.fr.
Abstract
BACKGROUND: The prognosis of cirrhotic patients in the Intensive Care Unit requires the development of predictive tools for mortality. We aimed to evaluate the ability of different prognostic scores to predict hospital mortality in these patients. METHODS: A single-centre retrospective analysis was conducted of 281 hospital stays of cirrhotic patients at an Intermediate Care Unit between June 2009 and December 2010. The performance of the Simplified Acute Physiology Score (SOFA), the Simplified Acute Physiology Score (SAPS) II or III, Child-Pugh, Model for End-Stage Liver Disease (MELD), MELD-Na and the Chronic Liver Failure-Consortium Acute-on-Chronic Liver Failure score (CLIF-C ACLF) in predicting hospital mortality were compared. RESULTS: Mean age was 58.2±12.1 years; 77% were male. The main cause of admission was acute gastrointestinal bleeding (47%). The in-hospital mortality rate was 25.3%. Receiver operating characteristic curve analyses demonstrated that SOFA (0.82) MELD-Na (0.82) or MELD (0.81) scores at admission predicted in-hospital mortality better than Child-Pugh (0.76), SAPS II (0.77), SAPS III (0.75) or CLIF-C ACLF (0.75). We then developed the cirrhosis prognostic score (Ci-Pro), which performed better (0.89) than SOFA. CONCLUSION: SOFA, MELD and especially the Ci-Pro score show the best performance in predicting hospital mortality of cirrhotic patients admitted to an Intermediate Care Unit.
BACKGROUND: The prognosis of cirrhotic patients in the Intensive Care Unit requires the development of predictive tools for mortality. We aimed to evaluate the ability of different prognostic scores to predict hospital mortality in these patients. METHODS: A single-centre retrospective analysis was conducted of 281 hospital stays of cirrhotic patients at an Intermediate Care Unit between June 2009 and December 2010. The performance of the Simplified Acute Physiology Score (SOFA), the Simplified Acute Physiology Score (SAPS) II or III, Child-Pugh, Model for End-Stage Liver Disease (MELD), MELD-Na and the Chronic Liver Failure-Consortium Acute-on-Chronic Liver Failure score (CLIF-C ACLF) in predicting hospital mortality were compared. RESULTS: Mean age was 58.2±12.1 years; 77% were male. The main cause of admission was acute gastrointestinal bleeding (47%). The in-hospital mortality rate was 25.3%. Receiver operating characteristic curve analyses demonstrated that SOFA (0.82) MELD-Na (0.82) or MELD (0.81) scores at admission predicted in-hospital mortality better than Child-Pugh (0.76), SAPS II (0.77), SAPS III (0.75) or CLIF-C ACLF (0.75). We then developed the cirrhosis prognostic score (Ci-Pro), which performed better (0.89) than SOFA. CONCLUSION: SOFA, MELD and especially the Ci-Pro score show the best performance in predicting hospital mortality of cirrhotic patients admitted to an Intermediate Care Unit.
Authors: Sara Blasco-Algora; José Masegosa-Ataz; María Luisa Gutiérrez-García; Sonia Alonso-López; Conrado M Fernández-Rodríguez Journal: World J Gastroenterol Date: 2015-11-14 Impact factor: 5.742
Authors: Michael Jahn; Jan Rekowski; Guido Gerken; Andreas Kribben; Ali Canbay; Antonios Katsounas Journal: PLoS One Date: 2019-09-25 Impact factor: 3.240