The systemic inflammatory response syndrome in cirrhotic patients: Relationship with their in-hospital outcome
The systemic inflammatory response syndrome in cirrhotic patients: Relationship with their in-hospital outcome
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DOI：
10.1016/j.jhep.2009.04.017
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发表时间：
2009-09-01
影响因子：
25.7
通讯作者：
Salerno, Francesco
中科院分区：
文献类型：
--
作者：
Cazzaniga, Massimo;Dionigi, Elena;Salerno, Francesco
背景/目的：有证据表明，全身炎症反应综合征（SIRS）是导致哮喘患者预后不良的原因之一。我们研究了141例连续入院的三级转诊中心评估SIRS的患病率及其与住院outcome.Methods的关系：SIRS的存在进行了评估入院和住院期间。主要临床结局为死亡和门脉高压相关并发症的发生。结果：39例患者符合SIRS标准。141例患者中有20例（14.1%）在入院时出现SIRS，而121例患者中有19例（15.7%）在住院期间出现SIRS。SIRS与入院时细菌感染相关（P = 0.02），黄疸（p = 0.011），高血清肌酐水平（p = 0.04），高血清胆红素水平（p = 0.002），高国际标准化比率（p = 0.046）、高终末期肝病模型（MELD）评分（p = 0.001）和高SOFA评分（p = 0.003）。在14 ± 8天的随访期间，16例患者死亡（11%），7例发生门静脉高压相关出血（5%），16例肝性脑病（11%）和5例肝肾综合征1型（3.5%）。SIRS与死亡（p < 0.001）和门脉高压相关并发症（p < 0.001）相关。在多变量分析中，SIRS和MELD独立与death.Conclusions：SIRS经常发生在晚期肝硬化患者，并与预后不良。(C)2009年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
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. (C) 2009 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.