Systemic inflammatory response syndrome in patients with liver cirrhosis.
OBJECTIVE
Patients with liver cirrhosis present an increased susceptibility to the systemic inflammatory response syndrome (SIRS), which is considered the cause of hospital admission in about 10% of patients and is present in about 40% of those admitted for ongoing complications. We tried to assess the prevalence of the SIRS with the possible effects on the course of the disease during hospital stay.


METHODS
Two hundred and three patients with liver cirrhosis were examined and investigated with close monitoring during hospital stay. The main clinical endpoints were death and the development of portal hypertension-related complications.


RESULTS
Eighty-one patients met the criteria of SIRS (39.9%). We found significant correlations between SIRS and jaundice (p=0.005), bacterial infection (p=0.008), white blood cell count (p<0.001), low haemoglobin concentration (p=0.004), high serum creatinine levels (p<0.001), high alanine aminotransferase levels (p<0.001), serum bilirubin levels (p<0.001), international normalised ratio (p<0.001), serum albumin levels (p=0.033), high Child-Pugh score (p<0.001). During the follow-up period, 26 patients died (12.8%), 15 developed portal hypertension-related bleeding (7.3%), 30 developed hepatic encephalopathy (14.7%), and 9 developed hepatorenal syndrome type-1 (4.4%). SIRS showed significant correlations both to death (p<0.001) and to portal hypertension-related complications (p<0.001).


CONCLUSIONS
The systemic inflammatory response syndrome occurs in patients with advanced cirrhosis and is associated with a bad prognosis.
Internal Medicine Department, Mansoura University, Mansoura, Egypt. ehabdr@yahoo.com
Ehab E
EE
Abdel-Khalek
Ashraf
A
El-Fakhry
Mohamed
M
Helaly
Magdy
M
Hamed
Osama
O
Elbaz
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001424:Bacterial Infections / Q000150:complications; D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications*; D006454:Hemoglobins / Q000378:metabolism; D006501:Hepatic Encephalopathy / Q000150:complications; D006530:Hepatorenal Syndrome / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D019934:International Normalized Ratio; D007565:Jaundice / Q000150:complications; D007902:Length of Stay; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012709:Serum Albumin / Q000378:metabolism; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000150:complications* / Q000401:mortality
D006454:Hemoglobins; D012709:Serum Albumin; D003404:Creatinine; D000410:Alanine Transaminase; D001663:Bilirubin