Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study

Mahassadi, Alassan Kouamé; Nguieguia, Justine Laure Konang; Kissi, H.; Awuah, Anthony Afum-Adjei; Bangoura, Aboubacar Demba; Doffou, Stanislas; Attia, Alain

doi:10.2147/ceg.s140655

Cited by 11 publications

(12 citation statements)

References 39 publications

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“…CRP is an acute inflammatory protein synthesized primarily in the liver and is a key component in systemic inflammation (Sproston and Ashworth, 2018). Systemic inflammation is associated with disease progression in liver cirrhosis and patient mortality, accompanying the transition from compensated to decompensated cirrhosis, otherwise known as the systemic inflammatory response syndrome (SIRS) (Girón-González et al, 2004;Mahassadi et al, 2018). SIRS is triggered by systemic and life-threatening insults to the body (Balk, 2014).…”

Section: Discussionmentioning

confidence: 99%

Organ System Network Disruption Is Associated With Poor Prognosis in Patients With Chronic Liver Failure

2020

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Background: A healthy individual has a high degree of functional connectivity between organ systems, which can be represented graphically in a network map. Disruption of this system connectivity is associated with mortality in life-threatening acute illnesses, demonstrated by a network approach. However, this approach has not been applied to chronic multisystem diseases and may be more reliable than conventional individual organ prognostic scoring methods. Cirrhosis is a chronic disease of the liver with multisystem involvement. Development of an efficient model for prediction of mortality in cirrhosis requires a profound understanding of the pathophysiologic processes that lead to poor prognosis. In the present study, we use a network approach to evaluate the differences in organ system connectivity between survivors and non-survivors in a group of well-characterized patients with cirrhosis. Methods: 201 patients with cirrhosis originally referred to the Clinic five at the University Hospital of Padova, with 13 clinical variables available representing hepatic, metabolic, haematopoietic, immune, neural and renal organ systems were retrospectively enrolled and followed up for 3, 6, and 12 months. Software was designed to compute the correlation network maps of organ system interaction in survivors and non-survivors using analysis indices: A. Bonferroni corrected Pearson's correlation coefficient and B. Mutual Information. Network structure was quantitatively evaluated using the measures of edges, average degree of connectivity and closeness, and qualitatively using clinical significance. Pair-matching was also implemented as a further step after initial general analysis to control for sample size and Model for End-Stage Liver Disease (MELD-Na) score between the groups. Results: There was a higher number of significant correlations in survivors, as indicated by both the analysis indices of Bonferroni corrected Pearson's correlation coefficient and the Mutual Information analysis. The number of edges, average degree of connectivity and closeness were significantly higher in survivors compared to non-survivors group. Pair-matching for MELD-Na was also associated with increased connectivity in survivors compared to non-survivors over 3 and 6 months follow up. Conclusion: This study demonstrates the application of a network approach in evaluating functional connectivity of organ systems in liver cirrhosis, demonstrating a

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Section: Discussionmentioning

confidence: 99%

Organ System Network Disruption Is Associated With Poor Prognosis in Patients With Chronic Liver Failure

2020

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“…Several blood markers and scoring systems have been developed to predict mortality in patients with cirrhosis. 10 The Child–Pugh score was initially created to improve the clinical management of cirrhotic patients. 11 The MELD score was developed to predict the cirrhosis progression using serum creatinine and bilirubin levels and the international normalized ratio (INR).…”

Section: Discussionmentioning

confidence: 99%

HDL-C levels added to the MELD score improves 30-day mortality prediction in Asian patients with cirrhosis

et al. 2022

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Objectives Lower high-density lipoprotein cholesterol (HDL-C) levels have been observed in chronic liver disease patients. The aim of this study was to develop a model that incorporates HDL-C levels and the Model for End-stage Liver Disease (MELD) score to predict 30-day mortality in Asian cirrhosis patients. Methods Cirrhosis patients were recruited from two hospitals in this retrospective observational study. Propensity score matching was used. The model’s performance was evaluated, including its ability to predict 30-day mortality, accuracy, and clinical utility. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated. Results The HDL-C + MELD model showed good ability to predict 30-day mortality (area under the curve, 0.784; sensitivity, 0.797; specificity, 0.632), which was better than that of the MELD score alone. It also showed good calibration and a net benefit for all patients, which was better than that of the MELD score, except at the threshold probability. NRI and IDI results confirmed that adding HDL-C levels to the MELD score improved the model’s performance in predicting 30-day mortality. Conclusion We added HDL-C levels to the MELD score to predict 30-day mortality in Asian patients with cirrhosis. The HDLC + MELD model shows good ability to predict 30-day mortality and clinical utility.

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“…After changing the solution 3 times, the cell line stably transfected with GFP lentivirus was obtained and photographed under a uorescence microscope. 4. Tree shrew grouping and treatment of umbilical cord mesenchymal stem cells:…”

Section: Body Temperature Observation and White Blood Cell Count Of Tree Shrews After Modelingmentioning

confidence: 99%

“…According to the characteristics of modern weapon injury, a repetitive systemic inflammatory response syndrome (SIRS) tree shrew model and model evaluation system were established to meet the actual needs of postwar medical protection. Blood biochemistry, histopathol-ogy and overall diagnostic indicators were screened, establishing a technical specification for the creation and evaluation of traumatic SIRS tree shrew models [Anderson and Singh, 2017;Garcia-Lamberechts et al, 2018;Li et al, 2018;Mahassadi et al, 2018]. Actually, the most used animals for the development of work related to the inflammatory response are mice or rats; however, in this work, we used tree shrews.…”

Section: Introductionmentioning

confidence: 99%

Establishment of a Systemic Inflammatory Response Syndrome Model and Evaluation of the Efficacy of Umbilical Cord Mesenchymal Stem Cell Transplantation

Ruan

Xiang

et al. 2021

Cells Tissues Organs

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Based on the characteristics of modern weapon injury, a repetitive model of traumatic systemic inflammatory response syndrome (SIRS) and an evaluation system were established. The models were treated with GFP-labeled tree shrew umbilical cord mesenchymal stem cells (UCMSCs). Forty out of 50 tree shrews were used to make a unilateral femoral comminuted fracture. Lipopolysaccharide was injected intravenously to create a traumatic SIRS model. The other 10 shrews were used as normal controls. After the model was established for 10 days, 20 tree shrews were injected intravenously with GFP-labeled UCMSCs, and 18 tree shrews were not injected as the model control group. The distribution of GFP-labeled cells in vivo was measured at 2 and 10 days after injection. Twenty days after treatment, the model group, the normal control group, and the treatment group were taken to observe the pathological changes in each tissue, and blood samples were taken for the changes in liver, renal, and heart function. Distribution of GFP-positive cells was observed in all tissues at 2 and 10 days after injection. After treatment, the HE staining results of the treatment group were close to those of the normal group, and the model group had a certain degree of lesions. The results of liver, renal, and heart function tests in the treatment group were returned to normal, and the results in the model group were abnormally increased. UCMSCs have a certain effect on the treatment of traumatic SIRS and provide a new technical solution for modern weapon trauma treatment.

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Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study

Cited by 11 publications

References 39 publications

Organ System Network Disruption Is Associated With Poor Prognosis in Patients With Chronic Liver Failure

Organ System Network Disruption Is Associated With Poor Prognosis in Patients With Chronic Liver Failure

HDL-C levels added to the MELD score improves 30-day mortality prediction in Asian patients with cirrhosis

Establishment of a Systemic Inflammatory Response Syndrome Model and Evaluation of the Efficacy of Umbilical Cord Mesenchymal Stem Cell Transplantation

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