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BMC Anesthesiology

, 14:123

Critical care

Abstract

BackgroundCirrhotic patients admitted to an intensive care unit ICU have high mortality rates. The present study compared the characteristics and outcomes of critically ill patients admitted to the ICU with and without cirrhosis using the matched Acute Physiology and Chronic Health Evaluation III APACHE III and Sequential Organ Failure Assessment SOFA scores.

MethodsA retrospective case-control study was performed at the medical ICU of a tertiary-care hospital between January 2006 and December 2009. Patients were admitted with life-threatening complications and were matched for APACHE III and SOFA scores. Of 336 patients enrolled in the study, 87 in the cirrhosis or noncirrhosis group were matched according to the APACHE III scores. Another 55 patients with cirrhosis were matched to the 55 patients without cirrhosis according to the SOFA scores. Demographic data, aetiology of ICU admission, and laboratory variables were also evaluated.

ResultsThe overall hospital mortality rate in the patients with cirrhosis in the APACHE III-matched group was more than that in their counterparts 73.6% vs 57.5%, P = .026 but the rate did not differ significantly in the SOFA-matched group 61.8% vs 67.3%. In the APACHE III-matched group, the SOFA scores of patients with cirrhosis were significantly higher than those of patients without cirrhosis P < .001, whereas the difference in APACHE III scores was nonsignificant between the SOFA-matched patients with and without cirrhosis.

ConclusionsScore-matched analytical data showed that the SOFA scores significantly differentiated the patients admitted to the ICU with cirrhosis from those without cirrhosis in APACHE III-matched groups, whereas difference in the APACHE III scores between the patients with and without cirrhosis were nonsignificant in the SOFA-matched group.

KeywordsAcute physiology and chronic health evaluation III APACHE III Sequential organ failure assessment SOFA Intensive care unit ICU Cirrhosis Outcome AbbreviationsICUintensive care unit

APACHE IIIAcute Physiology and Chronic Health Evaluation III

SOFASequential Organ Failure Assessment

RIFLERisk of renal failure, Injury to the kidney, Failure of kidney function, Loss of kidney function, and End-stage renal failure

AKIacute kidney injury

APSacute physiology score.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-14-123 contains supplementary material, which is available to authorized users.

Chung-Ming Fu, Chih-Hsiang Chang contributed equally to this work.

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Autor: Chung-Ming Fu - Chih-Hsiang Chang - Pei-Chun Fan - Ming-Hung Tsai - Shu-Min Lin - Kuo-Chin Kao - Ya-Chung Tian - Cheng-Chie

Fuente: https://link.springer.com/







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