Journal
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
Volume 11, Issue 9, Pages 857-864Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/17474124.2017.1338948
Keywords
Critically ill cirrhotic; acute respiratory failure; CLIF-SOFA; MELD; prognosis
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Funding
- National Natural Science Foundation of China [81500665]
- Scientific Research Foundation of Wenzhou [Y20160223]
- High Level Creative Talents from Department of Public Health in Zhejiang Province
- Project of New Century 551 Talent Nurturing in Wenzhou
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Background: Critically ill cirrhotic patients have a high mortality, particularly with concomitant respiratory failure on admission. There are no specific models in use for mortality risk assessment in critically ill cirrhotic patients with acute respiratory failure (CICRF). The aim is to develop a risk prediction model specific to CICRF in order to quantify the severity of illness.Methods: We analyzed 949 CICRF patients extracted from the MIMIC-III database. The novel model (ARF-CLIF-SOFA) was developed from the CLIF-SOFA score. Cox regression analysis and AUROC were implemented to test the predictive accuracy, compared with existing scores including the CLIF-SOFA score and MELD-related scores.Results: ARF-CLIF-SOFA contains PaO2/FiO(2) ratio, lactate, MAP, vasopressor therapy, bilirubin and creatinine (1 point each; score range: 0-6). Based on our patient cohort, the ARF-CLIF-SOFA score had good predictive accuracy for predicting the 30-, 90-day and 1-year mortality (AUROC=0.767 at 30-day, 0.768 at 90-day, 0.765 at 1-year, respectively). Additionally, the performance of the ARF-CLIF-SOFA is superior to existing scores (all P<0.001).Conclusion: The ARF-CLIF-SOFA score can be considered a CICRF specific score with a better predictive accuracy compared to the existing scores.
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