Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

‘Golden window’ for systemic inflammatory response syndrome in acute-on-chronic liver failure

The most recent issue of the Journal of Gastroenterology & Hepatology examines the course, and outcome of acute-on-chronic liver failure patients without systemic inflammatory response syndrome/sepsis.

News image

Systemic inflammatory response syndrome is an early marker of sepsis and ongoing inflammation and has been reported in large proportion of acute-on-chronic liver failure patients.

Whether sepsis is the cause or the result of liver failure is unclear and is vital to know.

Dr Ashok Choudhury and colleagues investigated the course, and outcome of acute-on-chronic liver failure patients without systemic inflammatory response syndrome/sepsis.

Consecutive acute-on-chronic liver failure patients were monitored for the development of systemic inflammatory response syndrome/sepsis and associated complications and followed till 90 days, liver transplant or death.

Of 561 patients, the team noted that 36% had no systemic inflammatory response syndrome and 64% had systemic inflammatory response syndrome with or without infection.

New onset systemic inflammatory response syndrome developed in 75%
Journal of Gastroenterology & Hepatology

New onset systemic inflammatory response syndrome and sepsis developed in 75% and 8% respectively in a median of 7 days, at a rate of 11% per day.

The researchers noted that cumulative incidence of new systemic inflammatory response syndrome was 29%, 93%, and 100% by days 4, 7, and 15.

Liver failure, that is, bilirubin > 12 mg/dL at days 0 and 4, and renal failure at day 4, independently predicted new onset systemic inflammatory response syndrome.

The team found that absence of systemic inflammatory response syndrome in the first week was associated with reduced incidence of organ failure, as was the 28-day, and 90-day mortality.

The 90-day mortality was 62% in the total cohort and that for those having no systemic inflammatory response syndrome and systemic inflammatory response syndrome at presentation were 43% and 65%, respectively.

Dr Choudhury's team concludes, "Liver failure predicts the development of systemic inflammatory response syndrome."

"New onset systemic inflammatory response syndrome in the first week is an important determinant of early sepsis, organ failure, and survival."

"Prompt interventions in this ‘golden window’ before development of sepsis may improve the outcome of acute-on-chronic liver failure."

J Gastroenterol Hepatol 2017: 32(12): 1989–1997
06 December 2017

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

 25 May 2018 
Colorectal cancer–specific mortality
 25 May 2018 
Technology to increase colorectal cancer screening
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Post‐operative complications in elderly IBD
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us