title: Effect of SIRS and sepsis on mortality in alcoholic hepatitis: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Sepsis is frequently observed in patients with alcoholic hepatitis (AH) and is an important mortality predictor. Several studies have also identified systemic inflammatory response syndrome (SIRS) as a significant prognostic factor. The aim of this study was to systematically review and quantify the effect of SIRS and sepsis on mortality in patients with AH.
  
  
  METHODS
  MEDLINE and EMBASE were searched from its inception till January 2016. Participants in the included studies were adults with AH and those with developed SIRS or sepsis during hospitalization. We estimated the risk ratio (RR) with a 95% confidence interval (CI) of mortality by comparing participants with SIRS vs. non-SIRS and sepsis vs. non-sepsis.
  
  
  RESULTS
  Data were extracted from six studies involving 1,264 patients (of whom 507 had SIRS) and four studies involving 57,529 patients (of whom 1,449 had sepsis). SIRS and sepsis were both significantly associated with mortality with RRs of 2.7 (95% CI 1.74-4.14, I2=50%) and 2.8 (95% CI 1.58-4.93, I2=94%), respectively.
  
  
  CONCLUSIONS
  Not only is sepsis associated with mortality but also SIRS. SIRS may be the initial trigger of cascade events leading to mortality in patients with AH. Identification of the key element of SIRS may thus provide a potential therapeutic target.
authors: Department of Internal Medicine, University of Hawaii, Honolulu, USA; Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. sikarin.upala@bassett.org.
authors: Veeravich
authors: V
authors: Jaruvongvanich
authors: Anawin
authors: A
authors: Sanguankeo
authors: Sikarin
authors: S
authors: Upala
mesh_terms: D005260:Female; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000401:mortality*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D016017:Odds Ratio; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality*; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000401:mortality*