Sepsis-related Organ Failure Assessment Score is a strong predictor of survival in acute-on-chronic liver failure
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Sepsis-related Organ Failure Assessment Score is a strong predictor of survival in acute-on-chronic liver failure. / Cold, Frederik; Schiødt, Frank Vinholt; Pott, Frank Christian; Strandkjær, Nina; Christensen, Erik.
In: Danish Medical Journal, Vol. 66, No. 8, A5557, 2019.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Sepsis-related Organ Failure Assessment Score is a strong predictor of survival in acute-on-chronic liver failure
AU - Cold, Frederik
AU - Schiødt, Frank Vinholt
AU - Pott, Frank Christian
AU - Strandkjær, Nina
AU - Christensen, Erik
N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
PY - 2019
Y1 - 2019
N2 - INTRODUCTION: The mortality of patients with an exacer-bation of decompensated liver cirrhosis is high even if treated in the intensive care unit (ICU), and the criteria for referral to ICU are not well defined. The objective of this study was to identify variables associated with mortality.METHODS: A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. A total of 53 adult patients with decompensated alcoholic liver cirrhosis were admitted from January 2012 to June 2015. Variables associated with survival were identified using Cox regression analysis.RESULTS: The ten-day, 30-day, 90-day, and one-year mortality were 36%, 57%, 66%, and 80%, respectively. Univariate Cox regression analysis showed that mortality was significantly associated with a low oxygen saturation, low diastolic blood pressure, terlipressin treatment, high Acute Physiology And Chronic Health Evaluation II score, high Simplified Acute Physiology Score II score, high Sepsis-related Organ Failure Assessment (SOFA) score and high Model For End-Stage Liver Disease score, but only a high SOFA score and old age were independently associated with increased mortality. These two variables were combined to the Age-SOFA index to predict the probability of surviving a given period.CONCLUSIONS: The mortality was high in these severely ill patients, even when they received optimum supportive therapy in the ICU. The finding that the SOFA score and age best predicted mortality shows that the increased mortality was caused mainly by insufficiency of organs other than the liver.FUNDING: none.TRIAL REGISTRATION: not relevant.
AB - INTRODUCTION: The mortality of patients with an exacer-bation of decompensated liver cirrhosis is high even if treated in the intensive care unit (ICU), and the criteria for referral to ICU are not well defined. The objective of this study was to identify variables associated with mortality.METHODS: A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. A total of 53 adult patients with decompensated alcoholic liver cirrhosis were admitted from January 2012 to June 2015. Variables associated with survival were identified using Cox regression analysis.RESULTS: The ten-day, 30-day, 90-day, and one-year mortality were 36%, 57%, 66%, and 80%, respectively. Univariate Cox regression analysis showed that mortality was significantly associated with a low oxygen saturation, low diastolic blood pressure, terlipressin treatment, high Acute Physiology And Chronic Health Evaluation II score, high Simplified Acute Physiology Score II score, high Sepsis-related Organ Failure Assessment (SOFA) score and high Model For End-Stage Liver Disease score, but only a high SOFA score and old age were independently associated with increased mortality. These two variables were combined to the Age-SOFA index to predict the probability of surviving a given period.CONCLUSIONS: The mortality was high in these severely ill patients, even when they received optimum supportive therapy in the ICU. The finding that the SOFA score and age best predicted mortality shows that the increased mortality was caused mainly by insufficiency of organs other than the liver.FUNDING: none.TRIAL REGISTRATION: not relevant.
KW - Acute-On-Chronic Liver Failure/mortality
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Critical Illness/mortality
KW - Denmark
KW - End Stage Liver Disease
KW - Female
KW - Hospital Mortality
KW - Hospitalization
KW - Humans
KW - Intensive Care Units
KW - Liver Cirrhosis/etiology
KW - Liver Cirrhosis, Alcoholic
KW - Male
KW - Middle Aged
KW - Organ Dysfunction Scores
KW - Prognosis
KW - Proportional Hazards Models
KW - ROC Curve
KW - Retrospective Studies
KW - Sepsis/complications
KW - Time Factors
M3 - Journal article
C2 - 31315795
VL - 66
JO - Danish Medical Journal
JF - Danish Medical Journal
SN - 2245-1919
IS - 8
M1 - A5557
ER -
ID: 238486255