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349869

Comparing Prognostic Scores of Mortality among Patients with Decompensated Liver Cirrhosis Admitted to the Medical Intensive Care Unit

Article

Last updated: 01 Jan 2025

Subjects

-

Tags

Internal Medicine

Abstract

Background: For mortality prediction models of decompensated liver cirrhosis to be valid, re-evaluations of score performances are needed. This research aimed to assess the prognostic scores performance in the prediction of mortality among decompensated cirrhotic patients admitted to the ICU, involving Acute Physiology and Chronic Health Evaluation II (APACHE II), sequential organ failure assessment (SOFA), Chronic Liver Failure Consortium acute-on-chronic liver failure (CLIF-C ACLF), Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), MELD Sodium (MELD-Na), MELD lactate, Glasgow Coma scale (GCS).

Methods: In an observational descriptive cohort study, we recruited 80 patients with decompensated liver cirrhosis who were critically ill and admitted to the ICU. Scores of the APACHE II, Child-Pugh, MELD, MELD-Na, and MELD-lactate were used to evaluate the severity of the disease.

Results: Statistically significant differences were revealed between ICU outcomes and different prognostic scores; as the median of CTP score, MELD, MELD Na, MELD Lactate (MELD.L), S. Lactate, SOFA, APACHE II & CLIF-C ACLF were higher among deceased patients, while the median of GCS & MAP was lower among deceased patients. By Multivariate regression analysis, low GCS (Odd Ratio:0.4), high CTP (OR: 2.37), and high APACHE II (OR: 2.44) were independent predictors of mortality (p<0.001), whereas serum sodium, albumin, platelets, hemoglobin, and blood urea were not.

Conclusion: When compared to previous models, SOFA and APACHE scores were superior in the predicting the overall mortality among patients at the ICU with decompensated liver cirrhosis.

DOI

10.21608/zumj.2024.282261.3327

Keywords

Prognostic Scores, mortality, Decompensated Liver Cirrhosis, Intensive Care Unit

Authors

First Name

Monkez

Last Name

Yousif

MiddleName

Motieh

Affiliation

Internal Medicine, Zagazig University

Email

rescurer165@yahoo.com

City

-

Orcid

-

First Name

Osama

Last Name

Mahmoud

MiddleName

Abdel Aziz

Affiliation

medical biochemistry faculty of medicine zagazig university

Email

osamashenawy60@gmail.com

City

-

Orcid

-

First Name

Mohamed

Last Name

Magahed

MiddleName

Khalid Lotfy

Affiliation

Internal Medicine Department, Faculty of Medicine, Zagazig University

Email

mohamed.khaled.7528610@gmail.com

City

-

Orcid

-

First Name

Ghada

Last Name

Samir

MiddleName

Mohamed

Affiliation

Internal Medicine, Zagazig University

Email

ghadasameer20@gmail.com

City

-

Orcid

-

Volume

30

Article Issue

4

Related Issue

48061

Issue Date

2024-07-01

Receive Date

2024-04-08

Publish Date

2024-07-01

Page Start

1,519

Page End

1,530

Print ISSN

1110-1431

Online ISSN

2357-0717

Link

https://zumj.journals.ekb.eg/article_349869.html

Detail API

https://zumj.journals.ekb.eg/service?article_code=349869

Order

349,869

Type

Original Article

Type Code

273

Publication Type

Journal

Publication Title

Zagazig University Medical Journal

Publication Link

https://zumj.journals.ekb.eg/

MainTitle

Comparing Prognostic Scores of Mortality among Patients with Decompensated Liver Cirrhosis Admitted to the Medical Intensive Care Unit

Details

Type

Article

Created At

30 Dec 2024