Cold Frederik, Schiødt Frank Vinholt, Pott Frank Christian, Strandkjær Nina, Christensen Erik
Dan Med J. 2019 Aug;66(8).
The mortality of patients with an exacer-bation of decompensated liver cirrhosis is high even if treated in the intensive care unit (ICU), and the criteria for referral to ICU are not well defined. The objective of this study was to identify variables associated with mortality.
A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. A total of 53 adult patients with decompensated alcoholic liver cirrhosis were admitted from January 2012 to June 2015. Variables associated with survival were identified using Cox regression analysis.
The ten-day, 30-day, 90-day, and one-year mortality were 36%, 57%, 66%, and 80%, respectively. Univariate Cox regression analysis showed that mortality was significantly associated with a low oxygen saturation, low diastolic blood pressure, terlipressin treatment, high Acute Physiology And Chronic Health Evaluation II score, high Simplified Acute Physiology Score II score, high Sepsis-related Organ Failure Assessment (SOFA) score and high Model For End-Stage Liver Disease score, but only a high SOFA score and old age were independently associated with increased mortality. These two variables were combined to the Age-SOFA index to predict the probability of surviving a given period.
The mortality was high in these severely ill patients, even when they received optimum supportive therapy in the ICU. The finding that the SOFA score and age best predicted mortality shows that the increased mortality was caused mainly by insufficiency of organs other than the liver.
none.
not relevant.
失代偿期肝硬化急性加重患者即便在重症监护病房（ICU）接受治疗，死亡率仍很高，且转入ICU的标准尚不明确。本研究的目的是确定与死亡率相关的变量。
在一所大学附属医院的ICU进行单中心回顾性队列分析。2012年1月至2015年6月期间，共收治了53例成年失代偿期酒精性肝硬化患者。使用Cox回归分析确定与生存相关的变量。
10天、30天、90天和1年的死亡率分别为36%、57%、66%和80%。单因素Cox回归分析显示，死亡率与低氧饱和度、低舒张压、特利加压素治疗、高急性生理与慢性健康状况评分II、高简化急性生理评分II、高脓毒症相关器官功能衰竭评估（SOFA）评分及高终末期肝病模型评分显著相关，但只有高SOFA评分和高龄与死亡率增加独立相关。将这两个变量合并为年龄-SOFA指数，以预测特定时期的生存概率。
这些重症患者的死亡率很高，即便他们在ICU接受了最佳支持治疗。SOFA评分和年龄最能预测死亡率这一发现表明，死亡率增加主要是由肝脏以外的器官功能不全所致。
无。
不相关。
