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Background: Patients with decompensated liver cirrhosis usually resulted in admission to the intensive care unit (ICU) during hospitalization. When admitted to the ICU, the mortality was high. The aim of this study is to identify multiple prognostic factors for mortality and to analyze the significance of prognostic survival model with each scoring system in patients with decompensated liver cirrhosis who was admitted to the ICU. Methods: From January 2008 to December 2008, 60 consecutive patients with decompensated liver cirrhosis were admitted in the ICU and retrospectively reviewed. Prognostic models used were Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), model for end-stage liver disease with incorporation of serum sodium (MELD-Na), acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment (SOFA). The predictive prognosis was analyzed using the area under the receiver’s operating characteristics curve (AUC). Results: The median follow up period was 20 months, and ICU mortality was 17% (n = 10). A total of 24 patients (40%) died during the study period. The average survival of five prognostic models was related with the severity of the disease. All of the five systems showed significant differences in the cumulative survival rate, according to the scores on admission, and the MELD-Na had the highest AUC (0.924). Multivariate analysis showed that bilirubin and albumin were significantly related to mortality. Conclusions: The CPT, MELD, MELD-Na, APACHE II, and SOFA may predict the prognosis of patients with decompensated liver cirrhosis. The MELD-Na could be a better prognostic predictor than other scoring systems.

권호기사

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참고문헌 (20건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Intensive care unit admissions with cirrhosis: Risk‐stratifying patient groups and predicting individual survival 네이버 미소장
2 Wang YW, Huo TI, Yang YY, Hou MC, Lee PC, Lin HC, et al: Correlation and comparison of the model for end-stage liver disease, portal pressure, and serum sodium for outcome prediction in patients with liver cirrhosis. J Clin Gastroenterol 2007; 41: 706-12. 미소장
3 Short‐term prognosis in critically ill patients with cirrhosis assessed by prognostic scoring systems 네이버 미소장
4 High incidence of hepatitis B infections among chronic hepatitis cases of unknown aetiology 네이버 미소장
5 APACHE II 네이버 미소장
6 Serial evaluation of the SOFA score to predict outcome in critically ill patients. 네이버 미소장
7 Cholongitas E, Senzolo M, Patch D, Kwong K, Nikolopoulou V, Leandro G, et al: Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit. Aliment Pharmacol Ther 2006; 23: 883-93. 미소장
8 MELD score is better than Child–Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt 네이버 미소장
9 Specific laboratory methodologies achieve higher model for endstage liver disease (MELD) scores for patients listed for liver transplantation 네이버 미소장
10 The model for end‐stage liver disease (MELD) 네이버 미소장
11 MELD fails to measure quality of life in liver transplant candidates 네이버 미소장
12 Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death 네이버 미소장
13 Evidence-Based Incorporation of Serum Sodium Concentration Into MELD 네이버 미소장
14 Singh N, Gayowski T, Wagener MM, Marino IR: Outcome of patients with cirrhosis requiring intensive care unit support: prospective assessment of predictors of mortality. J Gastroenterol 1998; 33: 73-9. 미소장
15 Butt AK, Khan AA, Alam A, Shah SW, Shafqat F, Naqvi AB: Predicting hospital mortality in cirrhotic patients: comparison of Child-Pugh and Acute Physiology, Age and Chronic Health Evaluation (APACHE III) scoring systems. Am J Gastroenterol 1998; 93: 2469-75. 미소장
16 Zauner CA, Apsner RC, Kranz A, Kramer L, Madl C, Schneider B, et al: Outcome prediction for patients with cirrhosis of the liver in a medical ICU: a comparison of the APACHE scores and liver-specific scoringsystems. Intensive Care Med 1996; 22: 559-63. 미소장
17 Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996; 22: 707-10. 미소장
18 Short‐term prognosis in critically ill patients with cirrhosis assessed by prognostic scoring systems 네이버 미소장
19 Prognostic models in cirrhotics admitted to intensive care units better predict outcome when assessed at 48 h after admission 네이버 미소장
20 Serial evaluation of the SOFA score to predict outcome in critically ill patients. 네이버 미소장