Help
Subscribe


Submit Videos to GastroHep 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

 23 May 2015

Advanced search
 22 May 2015 
Treatment with anti-integrin antibodies in IBD
 22 May 2015 
Care of patients with GERD
 22 May 2015 
Colonoscopy screening for colorectal cancer
 21 May 2015 
Imaging for hepatocellular carcinoma
 21 May 2015 
Lymphoma in IBD
 21 May 2015 
Serrated polyps and colorectal cancer
 20 May 2015 
Refractory metastatic colorectal cancer
 20 May 2015 
Pancreatic neuroendocrine tumors
 20 May 2015 
Surveillance in long-segment Barrett's
 19 May 2015 
PPIs and cryptogenic liver abscess
 19 May 2015 
Anti-integrin antibodies in IBD
 19 May 2015 
Metabolic syndrome and Barrett's
 18 May 2015 
HLA haplotypes and primary sclerosing cholangitis
 18 May 2015 
Safety of PPI
 18 May 2015 
ESPGHAN celiac guidelines
 15 May 2015 
Management of nonhospitalized ulcerative colitis
 15 May 2015 
Diabetes and infections in IBD with immunomodulation
 15 May 2015 
Microscopic colitis risk with PPIs/NSAIDs
 14 May 2015 
Diagnosis of spontaneous bacterial peritonitis
 14 May 2015 
Mortality in US patients with cirrhosis
 14 May 2015 
Radiation exposure during ERCP
 13 May 2015 
Predictors of IBD
 13 May 2015 
Psychological distress and liver disease mortality
 13 May 2015 
Hypnotherapy in IBS/IBD
 12 May 2015 
Bleeding in NSAID users with H.pylori
 12 May 2015 
Capsule colonoscopy detects colorectal polyps
 12 May 2015 
Anti-TNF biologics in acute severe ulcerative colitis
 11 May 2015 
Management of Barrett's esophagus
 11 May 2015 
Marker to detect recurrence of Crohn's
 11 May 2015 
Thalidomide for IBD
 08 May 2015 
Surveillance colonoscopy in colorectal cancer
 08 May 2015 
HCV treatment with compensated cirrhosis
 08 May 2015 
Medical management of Crohn's
 07 May 2015 
Surgical complications in ulcerative colitis
 07 May 2015 
Combination therapy for noncirrhostic patients
 07 May 2015 
Anxiety and new-onset dyspepsia
 06 May 2015 
PPIs and spontaneous bacterial peritonitis
 06 May 2015 
Infant feeding and celiac disease
 06 May 2015 
Preventing recurrent C. diff infection
 05 May 2015 
Fatigue in primary sclerosing cholangitis
 05 May 2015 
Annual CT scans after esophagectomy for cancer
 05 May 2015 
Prevalence of eosinophilic esophagitis
 04 May 2015 
Stress resilience and peptic ulcer disease
 04 May 2015 
Endoscope storage and microbial colonization
 04 May 2015 
Menarche and NAFLD
 01 May 2015 
Sleep and physical activity measured in Crohn's
 01 May 2015 
NAFLD progression from steatosis to fibrosing-steatohepatitis
 01 May 2015 
Dietary supplement hepatotoxicity
 30 April 2015 
Botulinum toxin A for the treatment of obesity
 30 April 2015 
Risk factors for primary sclerosing cholangitis
 30 April 2015 
Neoadjuvant chemoradiotherapy for esophageal cancer
 29 April 2015 
Liver enzyme elevations after anti-TNF therapy in IBD

 29 April 2015 
Hepatocellular carcinoma surveillance in HBV
 29 April 2015 
Response to sorafenib in hepatocellular carcinoma
 28 April 2015 
Risk factors of hepatocellular carcinoma
 28 April 2015 
Clinical outcomes after esophagectomy
 28 April 2015 
Alcohol drinking and risk of liver cirrhosis
 23 April 2015 
Gut microbiota modulation for alcoholic liver disease
 23 April 2015 
Moderate sodium restriction diet in cirrhosis
 23 April 2015 
Gastroesophageal junction disruption and obesity

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us