| Home | E-Submission | Sitemap | Editorial Office |  
top_img
Korean J Crit Care Med > Volume 28(2); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(2): 101-107. doi: https://doi.org/10.4266/kjccm.2013.28.2.101
집중 치료실에 입실한 비대상성 간경변 환자의 예후 인자 분석
이길재ㆍ이정남ㆍ김나혜*ㆍ김건국ㆍ이운기ㆍ백정흠ㆍ최상태ㆍ이원석ㆍ유병철ㆍ박연정†
가천대 길병원 외과, *안과, †내과
The Analysis of Prognostic Factors in Patients with Decompensated Liver Cirrhosis Admitted to the Medical Intensive Care Unit
Gil Jae Lee, Jung Nam Lee, Iris Naheah Kim, Keon Kuk Kim, Woon Kee Lee, Jeong Heum Baek, Sang Tae Choi, Won Suk Lee, Byung Chul Yu, Yeon Jeong Park
1Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea. kimkk@gilhospital.com
2Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea.
3Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
ABSTRACT
BACKGROUND: Patients with decompensated liver cirrhosis usually resulted in admission to the intensive care unit (ICU) during hospitalization. When admitted to the ICU, the mortality was high. The aim of this study is to identify multiple prognostic factors for mortality and to analyze the significance of prognostic survival model with each scoring system in patients with decompensated liver cirrhosis who was admitted to the ICU. METHODS: From January 2008 to December 2008, 60 consecutive patients with decompensated liver cirrhosis were admitted in the ICU and retrospectively reviewed. Prognostic models used were Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), model for end-stage liver disease with incorporation of serum sodium (MELD-Na), acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment (SOFA). The predictive prognosis was analyzed using the area under the receiver's operating characteristics curve (AUC). RESULTS: The median follow up period was 20 months, and ICU mortality was 17% (n = 10). A total of 24 patients (40%) died during the study period. The average survival of five prognostic models was related with the severity of the disease. All of the five systems showed significant differences in the cumulative survival rate, according to the scores on admission, and the MELD-Na had the highest AUC (0.924). Multivariate analysis showed that bilirubin and albumin were significantly related to mortality. CONCLUSIONS: The CPT, MELD, MELD-Na, APACHE II, and SOFA may predict the prognosis of patients with decompensated liver cirrhosis. The MELD-Na could be a better prognostic predictor than other scoring systems.
Key Words: Acute Physiology and Chronic Health Evaluation II (APACHE II); liver cirrhosis; model for end-stage liver disease (MELD); model for end-stage liver disease with incorporation of serum sodium (MELD-Na); Sequential Organ Failure Assessment (SOFA)
Editorial Office
#805-806, Yongseong Biztel, 109 Hangang-daero, Yongsan-gu, Seoul 04376, Korea
TEL: +82-2-2077-1533   FAX: +82-2-2077-1535   E-mail: acc@accjournal.org
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © The Korean Society of Critical Care Medicine. All rights reserved.                 developed in m2community
Close layer
prev next