Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

SOFA and MELD predicts intensive care mortality in cirrhosis

Mortality in intensive care with cirrhosis is high, and the latest Alimentary Pharmacology & Therapeutics shows that the Model for End-stage Liver Disease predicts the risk better than Acute Physiology and Chronic Health Evaluation II or Child-Pugh scores.

News image

Prognostic scores in an intensive care unit evaluate outcomes, but derive from cohorts containing few cirrhotic patients.

Professor Burroughs and colleagues from England evaluated 6-week mortality in cirrhotic patients admitted to an intensive care unit.

The investigative team compared general and liver-specific prognostic scores.

A total of 312 consecutive cirrhotic patients, of which 65% were alcoholic with a mean age of 50 years.

The investigators used multivariable logistic regression to evaluate admission factors associated with survival.

Child-Pugh, Model for End-stage Liver Disease (MELD), Acute Physiology and Chronic Health Evaluation (APACHE) II scores were assessed.

In addition, the team evaluated the Sequential Organ Failure Assessment (SOFA) scores.

The various scores were compared by receiver operating characteristic curves.

Cirrhotics in intensive care with 3 or more failing organ systems have 90% mortality
Alimentary Pharmacology & Therapeutics

The investigators found that the major indication for admission was respiratory failure, in 36%.

Median Child-Pugh, and Acute Physiology and Chronic Health Evaluation II scores were 11 and 18.

The team noted that Model for End-stage Liver Disease and Sequential Organ Failure Assessment scores were 24 and 11, respectively.

The investigators observed that 65% of patients died.

Survival improved over time.

Multivariate model factors included more organs failing, higher FiO2, lactate, urea and bilirubin.

The team found that these factors resulted in good discrimination.

This was similar to Sequential Organ Failure Assessment and Model for End-stage Liver Disease.

In addition, the team noted that it was superior to Acute Physiology and Chronic Health Evaluation II and Child-Pugh scores.

Professor Burroughs' team concluded, “Cirrhotics admitted to intensive care with 3 or more failing organ systems have 90% mortality.”

“The Royal Free model discriminated well and contained key variables of organ function.”

“Sequential Organ Failure Assessment and Model for End-stage Liver Disease were better predictors than Acute Physiology and Chronic Health Evaluation II or Child-Pugh scores.”

Aliment Pharmacol Ther 2006: 23(7): 883
24 March 2006

Go to top of page Email this page Email this page to a colleague

 21 September 2014

Advanced search
 19 September 2014 
Adhesions in abdominal and pelvic surgery
 19 September 2014 
Repeat colonoscopy among US Medicare
 19 September 2014 
Progression to liver cancer in HCV-infected Veterans
 18 September 2014 
Patient improvement following sacral neuromodulation
 18 September 2014 
Autoimmune diseases in functional gastrointestinal disorders
 18 September 2014 
New diagnostic score for hepatic steatosis
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Management of complex colon polyps
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes
 04 September 2014 
Colectomy rates for refractory ulcerative colitis
 04 September 2014 
Infliximab prevents long-term Crohn’s disease recurrence
 04 September 2014 
Histological recovery with gluten-free diet in celiac disease
 03 September 2014 
Predictors of response in Crohn's disease
 03 September 2014 
Diagnosis of atrophic gastritis
 03 September 2014 
Safety of reinitiation of infliximab therapy
 02 September 2014 
SSRIs and depression in Hep C
 02 September 2014 
Bariatric surgery for obesity
 02 September 2014 
Eosinophilic esophagitis in adults
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 01 September 2014 
Genetic variants in alcoholic liver disease
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 28 August 2014 
Predictoris of C. diff in out-patients
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease
 26 August 2014 
NAFLD and gastroesophageal reflux symptoms
 26 August 2014 
Adalimumab-treated patients with ulcerative colitis
 26 August 2014 
Wound healing after abdominoperineal resection
 25 August 2014 
Surgical management of rectourethral fistulas
 25 August 2014 
Biomarker analysis in biopsies for ulcerative colitis
 25 August 2014 
Ileocolic resection in Crohn's disease

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us