Relationship Between Etiology of Cirrhosis and Survival Among Patients Hospitalized in Intensive Care Units.
Relationship Between Etiology of Cirrhosis and Survival Among Patients Hospitalized in Intensive Care Units.
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DOI：
10.1016/j.mayocp.2021.08.025
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发表时间：
2022-03
影响因子：
8.9
通讯作者：
Simonetto DA
中科院分区：
文献类型：
--
作者：
Choi C;Choi DH;Spears GM;Peeraphatdit TB;Serafim LP;Gajic O;Kamath PS;Shah VH;Gallo de Moraes A;Simonetto DA
目的：比较ICU收治的酒精相关性肝硬化（ALC）患者与其他病因肝病患者的短期预后。此外，我们研究了快速顺序器官衰竭评估（qSOFA）能否准确预测各种病因肝硬化危重患者的败血症和住院死亡率。回顾性分析了2006年1月至2015年12月期间1174例连续入住ICU的肝硬化患者。关注的结局包括在ICU内、ICU后住院或ICU出院后30天的生存率。578例发现酒精相关性肝硬化（ALC）， 596例为非ALC组。ALC组与非ALC组ICU死亡率无显著差异（10.2% vs 11.7%， P= 0.40）。然而，ALC患者的icu后住院死亡率（10.0% vs 6.5%, P = 0.04）和icu出院后30天死亡率（18.7% vs 11.2%, P < 0.001）均显著高于ALC患者。持续戒酒并不比不戒酒更有生存优势。qSOFA对肝硬化患者脓毒症和住院死亡率的预测能力有限。酒精相关性肝硬化危重患者与其他病因肝硬化患者相比，在ICU出院后生存率降低，与戒酒无关。
To determine short-term outcomes of patients with alcohol-associated cirrhosis (ALC) admitted to the ICU compared to other etiologies of liver disease. In addition, we investigate whether quick sequential organ failure assessment (qSOFA) accurately predicts presence of sepsis and in-hospital mortality in critically ill patients with various etiologies of cirrhosis. A retrospective cohort of 1,174 consecutive patients with cirrhosis admitted to the ICU between January of 2006 and December of 2015 was analyzed. Outcomes of interest included survival rates within the ICU, post-ICU in-hospital, or at 30 days post-ICU discharge. 578 patients were found to have alcohol-associated cirrhosis (ALC) with 596 in non-ALC group. There was no significant difference in ICU mortality rates in ALC vs. non-ALC cohorts (10.2% vs 11.7%, P=.40). However, patients with ALC had significantly higher post-ICU in-hospital death (10.0% vs 6.5%, P =.04) as well as higher mortality at 30-day post-ICU discharge (18.7% vs 11.2%, P <.001). Sustained alcohol abstinence did not offer survival advantage over non-abstinence. The predictive power for qSOFA for sepsis and in-hospital mortality for patients with cirrhosis was limited. Critically ill patients with alcohol-associated cirrhosis have decreased survival after ICU discharge compared to patients with other etiologies of cirrhosis, independent of alcohol abstinence.
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DOI：
10.1001/jama.2016.0288
发表时间：
2016-02-23
期刊：
JAMA
影响因子：
--
作者：
Seymour CW;Liu VX;Iwashyna TJ;Brunkhorst FM;Rea TD;Scherag A;Rubenfeld G;Kahn JM;Shankar-Hari M;Singer M;Deutschman CS;Escobar GJ;Angus DC
通讯作者：
Angus DC
DOI：
10.1016/j.jceh.2012.11.002
发表时间：
2013-03-01
影响因子：
3
作者：
Singal, Ashwani K.;Kamath, Patrick S.
通讯作者：
Kamath, Patrick S.
影响因子：
--
作者：
Bruha, R;Dvorak, K;Svestka, T
通讯作者：
Svestka, T
影响因子：
24.5
作者：
Piano, Salvatore;Bartoletti, Michele;Angeli, Paolo
通讯作者：
Angeli, Paolo
影响因子：
120.7
作者：
Raith, Eamon P.;Udy, Andrew A.;Pilcher, David V.
通讯作者：
Pilcher, David V.