Year 2011 / Volume 103 / Number 4
Original
Prognostic scores in cirrhotic patients admitted to a gastroenterology intensive care unit

pp. 177-183

Paulo Freire, José M. Romãozinho, Pedro Amaro, Manuela Ferreira and Carlos Sofia

Abstract
Background: prognostic scores have been validated in cirrhotic patients admitted to general Intensive Care Units. No assessment of these scores was performed in cirrhotics admitted to specialized Gastroenterology Intensive Care Units (GICUs).

Aim: to assess the prognostic accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment
(SOFA), Model for End-stage Liver Disease (MELD) and Child - Pugh-Turcotte (CPT) in predicting GICU mortality in cirrhotic patients.

Methods: the study involved 124 consecutive cirrhotic admissions to a GICU. Clinical data, prognostic scores and mortality were recorded. Discrimination was evaluated with area under receiver operating characteristic curves (AUC). Calibration was assessed with Hosmer-Lemeshow goodness-of-fit test.

Results: GICU mortality was 9.7%. Mean APACHE II, SAPS II, SOFA, MELD and CPT scores for survivors (13.6, 25.4, 3.5, 18.0 and 8.6, respectively) were found to be significantly lower
than those of non-survivors (22.0, 47.5, 10.1, 30.7 and 12.5, respectively) (p < 0.001). All the prognostic systems showed good discrimination, with AUC = 0.860, 0.911, 0.868, 0.897 and
0.914 for APACHE II, SAPS II, SOFA, MELD and CPT, respectively.
Similarly, APACHE II, SAPS II, SOFA, MELD and CPT scores achieved good calibration, with p = 0.146, 0.120, 0.686, 0.267 and 0.120, respectively. The overall correctness of prediction
was 81.9%, 86.1%, 93.3%, 90.7% and 87.7% for the APACHE II, SAPS II, SOFA, MELD and CPT scores, respectively.

Conclusions: in cirrhotics admitted to a GICU, all the tested scores have good prognostic accuracy, with SOFA and MELD showing the greatest overall correctness of prediction.
Share Button
New comment
Comments
No comments for this article
Related articles
Citation tools
Paulo Freire, José M. Romãozinho, Pedro Amaro, Manuela Ferreira and Carlos Sofia . Prognostic scores in cirrhotic patients admitted to a gastroenterology intensive care unit. 177-183


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 697 visits.
This article has been downloaded 0 times.
Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology