Outcomes of critically ill patients with cirrhosis admitted to intensive care: an important perspective from the non‐transplant setting

Thomson, Sarah; Moran, Carl; Cowan, Matthew; Musa, S; Beale, Richard; Treacher, David; Hamilton, Mark A.; Grounds, RM; Rahman, TM

doi:10.1111/j.1365-2036.2010.04341.x

Cited by 48 publications

(54 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This reflects the trend towards improved outcomes of these patients over time [32], and compares to the 38% and 39% recently reported from two studies in British non-transplant ICUs [5,10]. A likely explanation for the low mortality rates may be the comparative low degree of hepatic dysfunction seen in our patients.…”

Section: Accepted M Manuscriptsupporting

confidence: 71%

“…The prospective nature of the study means that pre-intubation encephalopathy and GCS scores could be obtained. This means that certain scores such as SOFA and CTP are likely to be more robust than in previous studies, which have listed the inability to obtain pre-intubation encephalopathy scores as a significant limitation [5].…”

Section: Accepted M Manuscriptmentioning

confidence: 91%

“…Glasgow Alcoholic Hepatitis Score (GAHS) [22] was included based on recent evidence from Thomson et al suggesting it might be of use in a critical care setting [5]. The Acute Physiology and Chronic…”

Section: Methodsmentioning

confidence: 99%

“…Admissions with cirrhosis doubled in the UK between 2003 and 2008. This is likely to increase further [4,5].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The utility of scoring systems in critically ill cirrhotic patients admitted to a general intensive care unit

Emerson¹,

McPeake²,

O’Neill³

et al. 2014

Journal of Critical Care

View full text Add to dashboard Cite

Section: Accepted M Manuscriptsupporting

confidence: 71%

Section: Accepted M Manuscriptmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

“…Admissions with cirrhosis doubled in the UK between 2003 and 2008. This is likely to increase further [4,5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The utility of scoring systems in critically ill cirrhotic patients admitted to a general intensive care unit

Emerson¹,

McPeake²,

O’Neill³

et al. 2014

Journal of Critical Care

View full text Add to dashboard Cite

“…20 This may be attributed to improved prognosis of cirrhotic patients admitted to ICU with AVH. 19,44 We also demonstrated a high proportion of patients received prophylactic antibiotics (91%) and vasoactive medications (86%); both known to improve outcome of patients admitted with AVH. [45][46][47] MELD has been shown to be a predictor of short-term outcome post-AVH in patients with cirrhosis in studies from Europe and US.…”

Section: Discussionmentioning

confidence: 87%

Comparison of scoring systems and outcome of patients admitted to a liver intensive care unit of a tertiary referral centre with severe variceal bleeding

Al-Freah

Gera

Martini

et al. 2014

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Summary Background Acute variceal haemorrhage (AVH) is associated with significant mortality. Aims To determine outcome and factors associated with hospital mortality (HM) in patients with AVH admitted to intensive care unit (ICU) and to compare outcomes of patients requiring transfer to a tertiary ICU (transfer group, TG) to a local in‐patient group (LG). Methods A retrospective study of all adult patients (N = 177) admitted to ICU with AVH from 2000–2008 was performed. Results Median age was 48 years (16–80). Male represented 58%. Median MELD score was 16 (6–39), SOFA score was 8 (6–11). HM was higher in patients who had severe liver disease or critical illness measured by MELD, SOFA, APACHE II scores and number of failed organs (NFO), P < 0.05. Patients with day‐1 lactate ≥ 2 mmol/L had increased HM (P < 0.001). MELD score performed as well as APACHE II, SOFA and NFO (P < 0.001) in predicting HM (AUROC = 0.84, 0.81, 0.79 and 0.82, respectively P > 0.05 for pair wise comparisons). Re‐bleeding was associated with increased HM (56.9% vs. 31.6%, P = 0.002). The TG (n = 124) had less severe liver disease and critical illness and consequently had lower HM than local patients (32% vs. 57%, P = 0.002). TG patients with ≥2 endoscopies prior to transfer had increased 6‐week mortality (P = 0.03). Time from bleeding to transfer ≥3 days was associated with re‐bleeding (OR = 2.290, P = 0.043). Conclusions MELD score was comparable to ICU prognostic models in predicting mortality. Blood lactate was also predictive of hospital mortality. Delays in referrals and repeated endoscopy were associated with increased re‐bleeding and mortality in this group.

show abstract

Complications of Chronic Alcoholism That Affect Critical Illness

Jones¹

2017

Critical Care Toxicology

View full text Add to dashboard Cite

Outcomes of critically ill patients with cirrhosis admitted to intensive care: an important perspective from the non‐transplant setting

Cited by 48 publications

References 33 publications

The utility of scoring systems in critically ill cirrhotic patients admitted to a general intensive care unit

The utility of scoring systems in critically ill cirrhotic patients admitted to a general intensive care unit

Comparison of scoring systems and outcome of patients admitted to a liver intensive care unit of a tertiary referral centre with severe variceal bleeding

Complications of Chronic Alcoholism That Affect Critical Illness

Contact Info

Product

Resources

About