Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul;4(3):168-72.

Systemic Inflammatory Response Syndrome and MELD Score in Hospital Outcome of Patients with Liver Cirrhosis

Ramin Behroozian  1 , Mehrdad Bayazidchi  1 , Javad Rasooli  1
Affiliations

Systemic Inflammatory Response Syndrome and MELD Score in Hospital Outcome of Patients with Liver Cirrhosis

Ramin Behroozian et al. Middle East J Dig Dis. 2012 Jul.

Abstract

Background: The evidence saying that the rate of Systemic Inflammatory Response Syndrome (SIRS) is high in patients with advanced cirrhosis and portal hypertension, this could have negative outcome on patients prognosis.

Methods: This prospective study included 109 cirrhotic patients who were admitted to Imam Khomeini Hospital, affiliated with Orumieh University of Medical Sciences, during 2011-2012. The presence of SIRS and the model for end stage liver disease (MELD) were assessed on admission and during the hospital stay. SIRS was considered positive if patients had two or more of the following: temperature of >38ºC or <36ºC; heart rate >90 beats/min; respiratory rate >20/min or PaCO2 <32 mmHg or the use of mechanical ventilation; WBC >12000/mm(3) or <4000/mm(3) or more than 10% immature neutrophil count. MELD was calculated as: MELD = 3.8 [Ln serum bilirubin (mg/dl)] +11.2 [Ln INR] +9.6 [Ln serum creatinine (mg/dl)] +6.4. Hospital outcome was defined as death or hospital discharge.

Results: A total of 109 cirrhotic patients between the ages of 14 to 84 (mean: 54.6 ±18.4) years were included. There were 65 (59%) male patients. Of the 109 patients, 76 (69.8%) were SIRS-negative and 33 (30.2%) were SIRS-positive. The mean calculated MELD score for all patients was 15.5. There was a correlation noted between SIRS and high serum creatinine levels (p=0.01) and between SIRS and a high MELD score (p=0.00). During follow-up 19 (17.4%) patients died. SIRS was correlated with death (p<0.00) on multivariate analysis, SIRS was independently associated with hospital death.

Conclusion: SIRS is a relatively frequent event in cirrhotic patients admitted to referral centers. It is closely related to the severity of liver disease as shown by the MELD score. SIRS independently and adversely affects the in-hospital outcome in patients with liver cirrhosis.

Keywords: Cirrhosis; Hospital outcome; MELD; SIRS.

PubMed Disclaimer

References

    1. Thabut D, Massard J, Gangloff A, Carbonell N, Francoz C, Nguyen-Khac Nguyen-Khac. et al. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure. Hepatology. 2007;46:1872–82. - PubMed
    1. Tandon P, Garcia-Tsao G. Bacterial infection, sepsis, and multiorgan failure in cirrhosis. Semin Liver Dis. 2008;28:26–42. - PubMed
    1. Lach L, Gines P, Arroyo V, Rimola A, Tito` L, Badalamenti S. et al. Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology. 1988;94:482–7. - PubMed
    1. du Cheyron D, Bouchet B, Parienti JJ, Ramakers M, Charbon- neau P. The attributable mortality of acute renal failure in critically ill patients with liver cirrhosis. Intensive Care Med. 2005;31:1693–9. - PubMed
    1. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA. et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsisThe ACCP/SCCM Consensus Conference CommitteeAmerican College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101:1644–55. - PubMed

LinkOut - more resources