Prognosis of patients with cirrhosis and chronic liver disease admitted to the medical intensive care unit.
Patients with hepatic failure admitted to the medical ICU (MICU) generally have a poor prognosis. To determine if there were readily identifiable clinical factors associated with a high predictive value for outcome, we reviewed retrospectively the charts of 100 patients with serious liver disease admitted to the MICU. The overall mortality of the group was 64%. We found that Child's class, a need for mechanical ventilation, and an elevated serum creatinine had the greatest prognostic significance. Ninety-one percent of the patients receiving assisted ventilation, 89% of the patients in Child's class C, and 93% of the patients with creatinine values greater than 1.3 mg/dl died during their MICU admission. Furthermore, a multivariant regression analysis indicated that patients in Child's class C receiving mechanical ventilation who had an abnormal serum creatinine (greater than 1.3 mg/dl) during the first 72 h in the MICU had only a 2% survival rate.
Shellman
R G
RG
Department of Medicine, Duke University Medical Center, Durham.
Fulkerson
W J
WJ
DeLong
E
E
Piantadosi
C A
CA
D000328:Adult; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008103:Liver Cirrhosis / Q000145:classification / Q000401:mortality / Q000503:physiopathology*; D008107:Liver Diseases / Q000145:classification / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies