title: Prognostic parameters and risk stratification in intensive care patients with severe liver diseases.
abstract: OBJECTIVE
  Acute or chronic liver failure is associated with numerous complications and patients may require intensive care treatment, which is complex, time-consuming and often highly resource-intensive. Thus, it is necessary to identify clinical parameters that allow quick risk stratification.
  
  
  METHODS
  In 117 patients with acute or chronic liver failure requiring ICU admission, the clinical parameters, risk scores and results of microbiological examinations were documented and correlated with the outcome (survivor vs. non-survivor).
  
  
  RESULTS
  Predictors of outcome were: Child-Pugh-Score (p < 0.01), MELD-Score (p < 0.01), SAPS-II-Score (p < 0.05), bilirubin (p < 0.01), Glasgow Coma Scale (GCS) (p < 0.02), urine output (p < 0.01), requirement of catecholamine administration (p <0.004), serum creatinine (p < 0.01). The strongest predictors of outcome were in a multivariate model GCS (p = 0.006) and MELD-score (p = 0.001).
  
  
  CONCLUSIONS
  Risk stratification in our patient collective was feasible. Apart from parameters to assess kidney function and circulation, various scoring systems that had previously not been evaluated for this kind of patient collective seem to be the main predictors of outcome.
authors.affiliation: Department of Internal Medicine II, Department of Nuclear Medicine Ludwig Maximilians University Campus Großhadern, Marchioninistraße 15,81377 Munich, Germany. sebastian.lehner@med.uni-muenchen.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lehner
authors.forename: Hans Joachim
authors.initials: HJ
authors.lastname: Stemmler
authors.forename: Alexander
authors.initials: A
authors.lastname: Mück
authors.forename: Jan
authors.initials: J
authors.lastname: Braess
authors.forename: Klaus G
authors.initials: KG
authors.lastname: Parhofer
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002395:Catecholamines / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D005858:Germany; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D014554:Urination
chemical_list: D015415:Biomarkers; D002395:Catecholamines; D003404:Creatinine; D001663:Bilirubin