RIFLE classification as predictive factor of mortality in patients with cirrhosis admitted to intensive care unit.

6533b851fe1ef96bd12aa1f1

RESEARCH PRODUCT

RIFLE classification as predictive factor of mortality in patients with cirrhosis admitted to intensive care unit.

Steve Shaw James O'beirne Vincenza Calvaruso Andrew K. Burroughs Marco Senzolo Evangelos Cholongitas David Patch

subject

Adult Liver Cirrhosis Male medicine.medical_specialty Time Factors Risk Assessment Sensitivity and Specificity Severity of Illness Index law.invention Hepatorenal syndrome law Predictive Value of Tests Risk Factors Internal medicine Cause of Death Epidemiology medicine Health Status Indicators Humans Rifle APACHE Retrospective Studies Hepatology business.industry Gastroenterology Acute kidney injury Reproducibility of Results Odds ratio APACHE cirrhosis intensive care unit MELD renal failure RIFLE SOFA.Acute Kidney Injury Middle Aged medicine.disease Prognosis Intensive care unit Surgery Intensive Care Units Logistic Models ROC Curve Cohort Female business Kidney disease

description

Background and Aim: To evaluate the association of the Risk, Injury, Failure, Loss and End-stage renal failure (RIFLE) score on mortality in patients with decompensated cirrho- sis admitted to intensive care unit (ICU). Methods: A cohort of 412 patients with cirrhosis consecutively admitted to ICU was classified according to the RIFLE score. Multivariable logistic regression analysis was used to evaluate the factors associated with mortality. Liver-specific, Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) and RIFLE scores on admission, were compared by receiver-operator characteristic curves. Results: The overall mortality during ICU stay or within 6 weeks after discharge from ICU was 61.2%, but decreased over time (76% during first interval, 1989-1992 vs 50% during the last, 2005-2006, P < 0.001). Multivariate analysis showed that RIFLE score (odds ratio: 2.1, P < 0.001) was an independent factor significantly associated with mor- tality. Although SOFA had the best discrimination (area under receiver-operator charac- teristic curve = 0.84), and theAPACHE II had the best calibration, the RIFLE score had the best sensitivity (90%) to predict death in patients during follow up. Conclusions: RIFLE score was significantly associated with mortality, confirming the importance of renal failure in this large cohort of patients with cirrhosis admitted to ICU, but it is less useful than other scores.

year	journal	country	edition	language
2009-10-01

http://hdl.handle.net/10447/44678