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Clinical characteristics and prognostic factors of liver cirrhosis patients with systemic inflammatory response syndrome
Author(s) -
Yang Danhong,
Xie Yuanjun,
Pan Hongying,
Huang Yicheng,
Dai Yining,
Tong Yongxi,
Chen Meijuan
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12886
Subject(s) - medicine , gastroenterology , procalcitonin , white blood cell , systemic inflammatory response syndrome , cirrhosis , univariate analysis , hazard ratio , creatinine , c reactive protein , hepatic encephalopathy , confidence interval , proportional hazards model , multivariate analysis , sepsis , inflammation
Aim Our objective is to study the clinical characteristics of cirrhosis patients with SIRS and investigate its prognostic factors. Methods We analyzed 285 consecutive patients and their data were evaluated retrospectively. Data were compared in patients with/without SIRS during hospitalization. Univariate and multivariate Cox regression analyses were undertaken separately for cirrhotic patients with SIRS to assess predictive factors for 90‐day mortality. Results The mortality was 38.24% (52/136) in patients with SIRS and 6.04% (9/149) in patients without SIRS for 90‐day follow‐up ( P < 0.001). The univariate analysis showed gastrointestinal hemorrhage ( P < 0.001), hepatic encephalopathy ( P < 0.001), albumin <30 g/L ( P < 0.037), creatinine (Cr) >175 µmol/L ( P < 0.001), cholinesterase(ChE) activity <3000 U/L ( P = 0.019), white blood cell count ≥10 000 (109/L) ( P = 0.018), neutrophils ≥80% ( P = 0.018), C‐reactive protein (CRP) ≥25 mg/L ( P < 0.001), procalcitonin ≥1.0 ng/mL ( P = 0.007), Child–Pugh class C ( P < 0.001), septicemia ( P < 0.001), pulmonary infection ( P < 0.001),multi‐site infection ( P = 0.001), acute‐on‐chronic liver failure (ACLF) ( P < 0.001), and advanced hepatocellular carcinoma (HCC) ( P < 0.001). In multivariate analysis, only Cr ≥175 µmol/L (hazard ratio [HR] = 2.768; confidence interval [CI], 1.53–5.04; P = 0.001), C‐reactive protein ≥25 mg/L (HR = 3.179; CI, 1.772–7.03; P = 0.004), multi‐site infection (HR = 19.427; CI, 7.484–50.431; P < 0.001), ACLF (HR = 7.308; CI, 3.048–17.521; P < 0.001), advanced HCC (HR = 2.523; CI, 1.019–6.248; P = 0.045) were independent predictors of 90‐day mortality in cirrhotic patients with SIRS. Conclusion Cr ≥ 175 µmol/L, CRP ≥ 25 mg/L, multi‐site infection, ACLF, and advanced HCC independently predicted a higher rate of 90‐day mortality in liver cirrhosis with SIRS