Zauner C, Schneeweiss B, Kranz A, Klos H, Gendo A, Ratheiser K, Lenz K, Kramer L, Madl C
Department of Internal Medicine IV, Universitätskliniken, Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria.
Wien Klin Wochenschr. 1999 Oct 15;111(19):810-4.
We questioned whether heavy chronic alcohol abuse influences extrahepatic organ failure and ICU mortality in cirrhotic patients admitted to a medical intensive care unit.
Medical records of 208 consecutive cirrhotic critically ill patients were reviewed. Patients were classified into two groups. Group A comprised 144 patients with liver cirrhosis due to heavy chronic alcohol abuse and group B, 64 patients with liver cirrhosis due to non-alcoholic causes. The presence of extrahepatic organ failures in patients of both groups was assessed with parameters determined on the day of admission to the ICU. Furthermore, ICU mortality was determined.
The occurrence of extrahepatic organ failure was similar in group A and group B (83% vs. 80%; p = NS). The rate of extrahepatic organ failure was 1.7 +/- 1.2 organs in group A, compared to 1.4 +/- 1 organs in group B (p = NS). ICU mortality was 53% in group A and 44% in group B (p = NS). An increase in the number of extrahepatic organ failures was associated with a concomitant increase in ICU mortality in both groups of patients.
The occurrence of extrahepatic organ failure and ICU mortality was not different between patients with liver cirrhosis secondary to heavy chronic alcohol abuse and patients with liver cirrhosis due to nonalcoholic causes. Cirrhotic patients should be admitted to a medical intensive care unit for extended intensive care treatment prior to the occurrence of extrahepatic multiple organ failure, independent of the underlying aetiology.
我们探讨了重度慢性酒精滥用是否会影响入住内科重症监护病房的肝硬化患者的肝外器官衰竭及重症监护病房死亡率。
回顾了208例连续入住重症监护病房的肝硬化危重症患者的病历。患者分为两组。A组包括144例因重度慢性酒精滥用导致肝硬化的患者,B组包括64例因非酒精性病因导致肝硬化的患者。通过入住重症监护病房当天测定的参数评估两组患者肝外器官衰竭的情况。此外,还确定了重症监护病房死亡率。
A组和B组肝外器官衰竭的发生率相似(83%对80%;p=无统计学意义)。A组肝外器官衰竭的发生率为1.7±1.2个器官,B组为1.4±1个器官(p=无统计学意义)。A组重症监护病房死亡率为53%,B组为44%(p=无统计学意义)。两组患者肝外器官衰竭数量的增加均与重症监护病房死亡率的相应增加相关。
重度慢性酒精滥用继发肝硬化患者与非酒精性病因导致肝硬化患者的肝外器官衰竭发生率及重症监护病房死亡率并无差异。无论潜在病因如何,肝硬化患者在发生肝外多器官衰竭之前均应入住内科重症监护病房接受延长的重症监护治疗。