Cirrhotic patients in the medical intensive care unit: Early prognosis and long-term survival*

Das, Vincent; Boëlle, Pierre‐Yves; Galbois, Arnaud; Guidet, Bertrand; Maury, Éric; Carbonell, Nicolas; Moreau, Richard; Offenstadt, G.

doi:10.1097/ccm.0b013e3181f3dea9

Cited by 201 publications

(239 citation statements)

References 48 publications

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“…In our study, older age was independently associated with hospital deaths following AVH this also previously reported by Das et al [6] Du Cheyron et al [20].…”

Section: Discussionsupporting

confidence: 79%

“…Many factors have been studied and found to be associated with increased risk of mortality in patients with bleeding varices [5]. When cirrhotic patients admitted to intensive care unit, the use of liver prognostic models as child-pugh and MELD scores were found to be poor predictors of outcome [6]. But in patients with acute variceal hemorrhage it still remains unclear if these models could do well for risk stratification among this group of patients.…”

Section: Introductionmentioning

confidence: 99%

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Scoring Systems and Risk Stratification in Cirrhotic Patients with Acute Variceal Bleeding "Scoring in Variceal Bleeding"

Mohammad¹,

Morsy²

2016

J Liver

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Objectives: To find the most accurate, suitable and applicable scoring system used for prediction of outcome in cirrhotic patients with bleeding varices. Methods:This prospective study included 120 cirrhotic patients with acute variceal bleeding, admitted at Department of Tropical Medicine and Gastroenterology in Sohag University Hospital over a one-year period (1/2015 to 1/2016). Clinical, laboratory and endoscopic parameters were studied, Child-Pugh (CTP) classification score, Model for end-stage liver disease (MELD) score, Acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score and AIMS65 score were calculated for all patients, univariate, multivariate analysis and performance was performed for all taken parameters and the scores. Results:The 120 patients (92 male, 28 female) admitted during the study period, eight patients (6.67%) died in hospital. Higher age, presence of encephalopathy, rebleeding, and higher serum bilirubin were independent factors associated with higher hospital mortality. The largest area under the receiver operator curve (AUROC) was for AIMS65 score and SOFA score followed by MELD score and APACHEII score then Child score all of which achieved very good performance (AUROC > 0.8). AIMS 65 score has the best sensitivity, specificity negative and positive predictive values. Although AIMS65 score was not significantly different from MELD, SOFA, and APACHEII scores, it was the best among them in prediction of mortality.Conclusions: AIMS65 score is best simple and applicable scoring system to independently predict mortality in those patients.

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“…In our study, older age was independently associated with hospital deaths following AVH this also previously reported by Das et al [6] Du Cheyron et al [20].…”

Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Scoring Systems and Risk Stratification in Cirrhotic Patients with Acute Variceal Bleeding "Scoring in Variceal Bleeding"

Mohammad¹,

Morsy²

2016

J Liver

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“…Since the original paper, SOFA and modifications of SOFA have been used to prognosticate critically ill patients with liver cirrhosis and liver failure [108,109]. Moreau and colleagues primarily used the chronic liver failuresequential organ failure assessment (CLIF-SOFA) score to identify diagnostic criteria of ACLF in European patients with acute hepatic decompensation [2].…”

Section: Prognostic Scores For Aclfmentioning

confidence: 99%

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

et al. 2014

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The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. Due to the rapid advancements in the knowledge and available information, a consortium of members from countries across Asia Pacific, ''APASL ACLF Research Consortium (AARC),'' was formed in 2012. A large cohort of retrospective and prospective data of ACLF patients was collated and followed up in this data base. The current ACLF definition was reassessed based on the new AARC data base. These initiatives were concluded on a 2-day meeting in February 2014 at New Delhi and led to the development of the final AARC consensus. Only those statements which were based on the evidence and were unanimously recommended were accepted. These statements were circulated again to all the experts and subsequently presented at the annual conference of the APASL at Brisbane, on March 14, 2014. The suggestions from the delegates were analyzed by the expert panel, and the modifications in the consensus were made. The final consensus and guidelines document was prepared. After detailed deliberations and data analysis, the

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“…Many factors have been studied and found to be associated with increased risk of mortality in patients with bleeding varices (7). When cirrhotic patients are admitted to an intensive care unit, the use of liver prognostic models, such as the Child-Pugh and MELD scores, were found to be poor predictors of outcome (8). However, in patients with acute variceal hemorrhage, it still remains unclear if these models could do well in determining risk stratification among this group of patients.…”

Section: Introductionmentioning

confidence: 99%

Variceal bleeding in cirrhotic patients: What is the best prognostic score?

Mohammad

Morsy²,

Ali³

2016

Turk J Gastroenterol

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Cirrhotic patients in the medical intensive care unit: Early prognosis and long-term survival*

Cited by 201 publications

References 48 publications

Scoring Systems and Risk Stratification in Cirrhotic Patients with Acute Variceal Bleeding "Scoring in Variceal Bleeding"

Scoring Systems and Risk Stratification in Cirrhotic Patients with Acute Variceal Bleeding "Scoring in Variceal Bleeding"

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

Variceal bleeding in cirrhotic patients: What is the best prognostic score?

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