title: CLIF-SOFA score and SIRS are independent prognostic factors in patients with hepatic encephalopathy due to alcoholic liver cirrhosis.
abstract: Hepatic encephalopathy (HE) is a complication associated with worst prognosis in decompensated liver cirrhosis (LC) patients. Previous studies have identified prognostic factors for HE, and recent studies reported an association between systemic inflammatory response syndrome (SIRS) and liver disease. This study aimed to identify prognostic factors for 30-day mortality in alcoholic LC patients with HE who visited the emergency department (ED).This was a retrospective study of alcoholic LC patients with HE from January 1, 2010, to April 30, 2015. The baseline characteristics, complications of portal hypertension, laboratory values, Child-Pugh class, Model for End-stage Liver Disease (MELD) score, chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score, and SIRS criteria were assessed. The presence of 2 or more SIRS criteria was considered SIRS. The primary outcomes were 30-day mortality and prognostic factors for patients with HE visiting the ED.In total, 105 patients who met the inclusion criteria were analyzed. Overall, the 30-day mortality rate was 6.7% (7 patients).Significant variables were hepatorenal syndrome, international normalized ratio, white blood cell count, total bilirubin level, MELD score CLIF-SOFA score, and SIRS in univariate analysis. CLIF-SOFA score and SIRS were the significant factors in the multivariate analysis (hazard ratio 5.56, 15.98; 95% confidence interval 1.18-26.18, 1.58-161.37; P = 0.03, P = 0.02). The mortality rates differed according to the CLIF-SOFA score (P < 0.01).The CLIF-SOFA score and SIRS in alcoholic LC patients with HE visiting the ED are independent predictors of 30-day mortality.
authors.affiliation: aDepartment of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do, Republic of Korea bDepartment of Neurosurgery, Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do, Republic of Korea cGyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do, Republic of Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Jeong
authors.forename: In Sung
authors.initials: IS
authors.lastname: Park
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Kim
authors.forename: Seong Chun
authors.initials: SC
authors.lastname: Kim
authors.forename: Changwoo
authors.initials: C
authors.lastname: Kang
authors.forename: Soo Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Tae Yun
authors.initials: TY
authors.lastname: Kim
authors.forename: Sang Bong
authors.initials: SB
authors.lastname: Lee
mesh_terms: D058625:End Stage Liver Disease / Q000209:etiology*; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011379:Prognosis; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*