Ankara Numune Education and Research Hospital, Ankara, Turkey.
Ann Hepatol. 2012 Jul-Aug;11(4):513-8.
The use of prognostic models for cirrhotic patients admitted to the medical intensive care unit (ICU) is of great importance, since they provide an objective evaluation for a group of patients with high mortality rates and high resource utilization.
To evaluate the validity and to compare the prognostic predictive value of the CTP, MELD, SOFA and APACHE II scoring systems in cirrhotic patients admitted to the ICU, the CTP and MELD models being exclusive for patients with liver disease.
Commonly used predictors of mortality such as age, sex, CTP, MELD, APACHE II and SOFA were evaluated, and their prognostic value was investigated.
A total of 201 patients were included in this study. Patients who survived had mean CTP score of 9.5 ± 2.4, MELD score 18.1 ± 7.1, APACHE II score of 13.4 ± 4.8 and SOFA score of 4.2 ± 2.6, compared to respective scores of 11.4 ± 2.8, 28.0 ± 11.2, 24.6 ± 10.4 and 8.7 ± 4.0 in patients who died. The difference between groups was statistically significant for each of one of the scoring systems (p < 0.001).
In this study, SOFA was found to be the most powerful predictor of prognosis for cirrhotic patients admitted to the ICU. This was followed by APACHE II, MELD and CTP models, in descending order of strength (AUROC values of 0.847, 0.821, 0.790 and 0.724, respectively).
使用预后模型对入住重症监护病房（ICU）的肝硬化患者进行评估非常重要，因为这些模型可以为一组死亡率和资源利用率均较高的患者提供客观评估。
评估 CTP、MELD、SOFA 和 APACHE II 评分系统在入住 ICU 的肝硬化患者中的有效性，并比较其预后预测价值，其中 CTP 和 MELD 模型仅适用于肝病患者。
评估了年龄、性别、CTP、MELD、APACHE II 和 SOFA 等常用死亡率预测因子，并研究了其预后价值。
本研究共纳入 201 例患者。存活患者的 CTP 评分、MELD 评分、APACHE II 评分和 SOFA 评分分别为 9.5 ± 2.4、18.1 ± 7.1、13.4 ± 4.8 和 4.2 ± 2.6，而死亡患者的 CTP 评分、MELD 评分、APACHE II 评分和 SOFA 评分分别为 11.4 ± 2.8、28.0 ± 11.2、24.6 ± 10.4 和 8.7 ± 4.0，各评分系统组间差异均具有统计学意义（p < 0.001）。
在本研究中，SOFA 被发现是预测入住 ICU 的肝硬化患者预后的最有力指标。其次是 APACHE II、MELD 和 CTP 模型，其预测能力依次降低（AUROC 值分别为 0.847、0.821、0.790 和 0.724）。
