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Assessing the prognosis of cirrhotic patients in the intensive care unit:What we know and what we need to know better

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World Journal of Hepatology 2021年第10期13卷 1341-1350页

作者： Fernando da Silveira Pedro H R Soares Luana Q Marchesan Roberto S A da Fonseca Wagner L Nedel Programa de Pos-Graduacao em Pneumologia Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil Intensive Care Unit Grupo Hospitalar ConceiçãoPorto Alegre 91430835Brazil Programa de Pos-Graduacao em Neurociencias Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil Programa de Pos-Graduacao em Ciencias da Saude Universidade Federal de Santa MariaSanta Maria 97105900Brazil Programa de Pos-Graduacao em Bioquimica Universidade Federal do Rio Grande do SulPorto Alegre 91430835Brazil

Critically ill cirrhotic patients have high in-hospital mortality and utilize significant health care resources as a consequence of the need for multiorgan *** this fact,their mortality has decreased in recent decades due to improved care of critically ill ***-on-chronic liver failure(ACLF),sepsis and elevated hepatic scores are associated with increased mortality in this population,especially among those not eligible for liver *** score is superior to another in the prognostic assessment of these patients,and both liver-specific and intensive care unit-specific scores have satisfactory predictive *** sequential assessment of the scores,especially the Sequential organ Failure Assessment(SOFA)and Chronic Liver Failure Consortium(CLIF)-SOFA scores,may be useful as an auxiliary tool in the decision-making process regarding the benefits of maintaining supportive therapies in this population.A CLIF-ACLF>70 at admission or at day 3 was associated with a poor prognosis,as well as SOFA score>19 at baseline or increasing SOFA score>*** studies addressing the prognostic assessment of these patients are necessary.

关键词： Cirrhosis Extrahepatic organ failure organ replacement therapy Mortality Prognostic scores Chronic Liver Failure Consortium-Sequential organ Failure Assessment Sequential organ Failure Assessment Model for End-stage Liver Disease

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