[Predicting mortality for 205 cirrhotic patients by APARCHEIII score system].
OBJECTIVE
To evaluate the prognostic value of APARCHEIII (acute physiology, age and chronic health evaluation) score system for cirrhosis patients.


METHODS
The clinic data of 205 cirrhotic patients were prospectively collected, APARCHEIII and Child-Pugh scores for each patient were recorded on admission day. Using discrimination analysis, the predictive accuracy of the two systems was investigated.


RESULTS
The complication included GI bleeding (15.6%), encephalopathy (10.6%), hepatorenal syndrome (8.8%), primary liver carcinoma (8.8%), and spontaneous bacterial peritonitis (4.8%). Fifty patients (24%) died. The major cause of death was GI bleeding (40%), hepatorenal syndrome (34%), hepatic failure (20%) and spontaneous bacterial peritonitis (6%). APARCHEIII and Child score for survivors was 19.3+/-8.6 and 7.4+/-1.8, significantly lower than those for nonsurvivors (47.9+/-20.1 and 10.6+/-2.4). APARCHEIII score system correctly predicted 82.3% of death cases vs 72.7% for Child system. When combined with the information of ascites and prothrombin prolongation time, 88.2% cases could be correctly identified in advance.


CONCLUSIONS
The APARCHEIII score system is a more efficient and accurate predictive system than Child for prognosticating short-term survival of cirrhotic patients and worth use in clinic.
Wang
H
H
Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
Liu
S
S
D018806:APACHE; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis