The systemic inflammatory response syndrome in cirrhotic patients: relationship with their in-hospital outcome.
J Hepatol
; 51(3): 475-82, 2009 Sep.
Article
en En
| MEDLINE
| ID: mdl-19560225
ABSTRACT
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.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Mortalidad Hospitalaria
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Síndrome de Respuesta Inflamatoria Sistémica
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Cirrosis Hepática
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Italia