Increased risk of cognitive impairment in cirrhotic patients with bacterial infections

Merli, Manuela; Lucidi, C.; Pentassuglio, I.; Giannelli, V.; Giusto, M.; Gregorio, V. Di; Pasquale, Chiara; Nardelli, Silvia; Lattanzi, Barbara; Venditti, Mario; Riggio, Oliviero

doi:10.1016/j.jhep.2013.03.012

Cited by 74 publications

(66 citation statements)

References 30 publications

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“…Thus, we suggest that patients with a high preoperative PLT had a significantly worse OS and RFS, as well as a higher risk of recurrence compared to patients with a PLT 6156 Â 10 9 /L, which is consistent with previous studies [3,4]. These findings support the hypothesis that PLT could be a confounder and should be adjusted when estimating the independent significance of the type of treatment or other factors.…”

Section: Referencessupporting

confidence: 91%

“…Moreover, 22% of the surgical patients and 13% of the TACE patients were not cirrhotic, but for those patients who were cirrhotic, more Child-Pugh B patients were in the TACE group (although this approached, but did not reach statistical significance). Finally, the authors highlight the poorer than anticipated outcomes from TACE and the lack of access to drug eluted beads [3][4][5][6]. The lack of access to these treatments is understandable, but the questions remain: ''Would the outcomes have been different had this been available''?…”

mentioning

confidence: 99%

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Partial hepatectomy vs. transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: A RCT

Metussin

Patanwala

Cross

2015

Journal of Hepatology

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Section: Referencessupporting

confidence: 91%

mentioning

confidence: 99%

Partial hepatectomy vs. transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: A RCT

Metussin

Patanwala

Cross

2015

Journal of Hepatology

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“…36 Evidence that deterioration of neuropsychological test scores in patients with cirrhosis with SIRS that resolve with resolution of SIRS, suggest that SIRS mediators, such as NO and proinflammatory cytokines, may be important in modulating the cerebral effect of ammonia. 37 The development of hepatic encephalopathy in septic patients with cirrhosis is associated with worse prognosis.…”

Section: Hepatic Encephalopathymentioning

confidence: 99%

Infections in Liver Disease

Nanchal

Ahmad

2016

Critical Care Clinics

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“…In addition, there is a further increase in the liverrelated complications and development of acute-on-chronic liver failure (ACLF) syndrome with liver and other distant organ failure, inflammation being the central driver of these changes. Indeed, it is well known that infections can precipitate variceal bleeding [5] and hepatic encephalopathy [6,7], and are associated with high risk of acute renal failure [8,9].…”

Section: Introductionmentioning

confidence: 99%

Early invasive fungal infections and colonization in patients with cirrhosis admitted to the intensive care unit

Theocharidou

Agarwal

Jeffrey

et al. 2016

Clinical Microbiology and Infection

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Bacterial infections in cirrhosis are common and associated with increased mortality, but little is known about fungal infections. The aim of this study, a sub-analysis of the Fungal Infection Risk Evaluation study, was to assess the incidence and implications of early invasive fungal disease (IFD) in patients with cirrhosis admitted to intensive care units (ICU). Clinical and laboratory parameters collected in the first 3 days of ICU stay for 782 patients with cirrhosis and/or portal hypertension were analysed and compared with those of 273 patients with very severe cardiovascular disease (CVD). The CVD patients had more co-morbidities and higher APACHE II scores. The overall incidence of IFD was similar in the two groups, but the incidence of IFD in ICU was higher in liver patients (1% versus 0.4%; p 0.025) as was fungal colonization (23.8% versus 13.9%; p 0.001). The ICU and in-hospital mortality, and length of stay were similar in the two groups. A higher proportion of liver patients received antifungal therapy (19.2% versus 7%; p <0.0005). There was no difference in mortality between colonized patients who received antifungal therapy and colonized patients who did not. The incidence of IFD in patients with cirrhosis in ICU is higher compared with another high-risk group, although it is still very low. This risk might be higher in patients with advanced liver disease admitted with acute-on-chronic liver failure, and this should be investigated further. Our data do not support prophylactic use of antifungal therapy in cirrhosis. Clinical Microbiology and Infection

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Increased risk of cognitive impairment in cirrhotic patients with bacterial infections

Cited by 74 publications

References 30 publications

Partial hepatectomy vs. transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: A RCT

Partial hepatectomy vs. transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: A RCT

Infections in Liver Disease

Early invasive fungal infections and colonization in patients with cirrhosis admitted to the intensive care unit

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