Clinical Characteristics and prognostic factors of liver cirrhosis patients with Systemic inflammatory response syndrome.

Yang D, Xie Y, Pan H et al.

Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang Province, China.

Hepatology research : the official journal of the Japan Society of Hepatology. Mar 2017.

Current assessment of prognostic factors in cirrhosis patients with SIRS is not accurate. There are few reports in the literature, which makes it difficult to determine an indication for cirrhosis patients with SIRS.To study the clinical characteristics in cirrhosis with SIRS and investigate its prognostic factors,we analysed 285 consecutive cirrhosis patients with SIRS and .their database were evaluated retrospectively.Data were compared in patients with/without SIRS during hospitalization.Univariate and multivariate Cox regression analyses were performed separately for cirrhotic patients with SIRS to assess predictive factors for 90-day mortality.The mortality was 38.24% (52/136) in patients with SIRS and 6.04% (9/149) in patients without SIRS for 90-day follow-up (P < 0.001). The univariate analysis showed gastrointestinal hemorrhage (P <0.001), hepatic encephalopathy (P < 0.001), ALB <30 g/L(P = 0.037), Cr >175 µmol/L (P < 0.001), CHE activity < 3000U/L (P = 0.019),WBC count ≥ 10000(10(9) /L )(P = 0.018), NE percent ≥80%(P = 0.018), CRP ≥ 25 mg/L(P < 0.001) and PCT ≥1.0 ng/mL (P = 0.007), Child-Pugh class C (P < 0.001) , septicemia (P <0.001), pulmonary infection (P <0.001) ,multi-site infection (P < 0.001),ACLF(P <0.001)and advanced HCC(P < 0.001). In multivariate analysis, only Cr ≥175 µmol/L (HR = 2.768; CI 1.53-5.04;P = 0.001), CRP ≥ 25 mg/L (HR = 3.179; CI 1.772-7.03;P = 0.004 ),multi-site infection (HR = 19.427; CI 7.484-50.431,P < 0.001), ACLF(HR = 7.308,CI 3.048-17.521,P < 0.001),advanced HCC(HR = 2.523;CI 1.019-6.248,P = 0.045) were independent predictors of 90-day mortality in cirrhotic patients with SIRS. From these results,Cr ≥ 175 µmol/L, CRP ≥ 25 mg/L,multi-site infection, ACLF and advanced HCC independently predicted a higher rate of 90-day mortality in liver cirrhosis with SIRS. Pubmed

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