Organ system failure scoring system can predict hospital mortality in critically III cirrhotic patients

Ming Hung Tsai, Yung Chang Chen, Yu Pin Ho, Ji Tseng Fang, Jau Min Lien, Cheng Tang Chiu, Nai Jen Liu, Pang chi Chen

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)

Abstract

Goals: This study was conducted to assess and compare the accuracy of Child-Pugh classification and organ system failure (OSF) scores, obtained on the first day of ICU admission, in predicting the hospital mortality in critically ill cirrhotic patients. Background: Cirrhotic patients admitted to the medical intensive care unit (ICU) are associated with high mortality rates. The prognosis of critically ill cirrhotic patients is determined by the extent of hepatic and extrahepatic organ dysfunction. Study: A total of 111 patients diagnosed with liver cirrhosis were admitted to medical ICU from July 2001 to June 2002. Information considered necessary to compute the Child-Pugh and OSF scores on the first day of ICU admission was prospectively collected. Results: The overall hospital mortality rate was 64.9%. Liver disease was most commonly attributed to hepatitis B viral infection. The OSF scores demonstrate a good fit using the Hosmer and Lemeshow goodness-of-fit test. Meanwhile, by using the areas under receiver operating characteristic (AUROC) curve, the OSF scores demonstrated an excellent discriminative power (AUROC 0.901), whereas the performance of Child-Pugh scores is clearly poorer (AUROC 0.748). Conclusion: This investigation confirms that the prognosis for cirrhotic patients admitted to ICU is grave. The OSF score is a simple, reproducible, and easily applied tool with excellent prognostic abilities that can provide objective information for patients' families and physicians and supplement the clinical judgment of prognosis.

Original languageEnglish
Pages (from-to)251-257
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume37
Issue number3
DOIs
Publication statusPublished - Sep 2003
Externally publishedYes

Keywords

  • ICU
  • Liver cirrhosis
  • Prognosis

ASJC Scopus subject areas

  • Gastroenterology

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