title: Clinical characteristics and prognostic factors of liver cirrhosis patients with systemic inflammatory response syndrome.
abstract: OBJECTIVE
  Our objective is to study the clinical characteristics of cirrhosis patients with SIRS and investigate its prognostic factors.
  
  
  METHODS
  We analyzed 285 consecutive patients and their data were evaluated retrospectively. Data were compared in patients with/without SIRS during hospitalization. Univariate and multivariate Cox regression analyses were undertaken separately for cirrhotic patients with SIRS to assess predictive factors for 90-day mortality.
  
  
  RESULTS
  The mortality was 38.24% (52/136) in patients with SIRS and 6.04% (9/149) in patients without SIRS for 90-day follow-up (P < 0.001). The univariate analysis showed gastrointestinal hemorrhage (P < 0.001), hepatic encephalopathy (P < 0.001), albumin <30 g/L (P < 0.037), creatinine (Cr) >175 µmol/L (P < 0.001), cholinesterase(ChE) activity <3000 U/L (P = 0.019), white blood cell count ≥10 000 (109/L) (P = 0.018), neutrophils ≥80% (P = 0.018), C-reactive protein (CRP) ≥25 mg/L (P < 0.001), procalcitonin ≥1.0 ng/mL (P = 0.007), Child-Pugh class C (P < 0.001), septicemia (P < 0.001), pulmonary infection (P < 0.001),multi-site infection (P = 0.001), acute-on-chronic liver failure (ACLF) (P < 0.001), and advanced hepatocellular carcinoma (HCC) (P < 0.001). In multivariate analysis, only Cr ≥175 µmol/L (hazard ratio [HR] = 2.768; confidence interval [CI], 1.53-5.04; P = 0.001), C-reactive protein ≥25 mg/L (HR = 3.179; CI, 1.772-7.03; P = 0.004), multi-site infection (HR = 19.427; CI, 7.484-50.431; P < 0.001), ACLF (HR = 7.308; CI, 3.048-17.521; P < 0.001), advanced HCC (HR = 2.523; CI, 1.019-6.248; P = 0.045) were independent predictors of 90-day mortality in cirrhotic patients with SIRS.
  
  
  CONCLUSIONS
  Cr ≥ 175 µmol/L, CRP ≥ 25 mg/L, multi-site infection, ACLF, and advanced HCC independently predicted a higher rate of 90-day mortality in liver cirrhosis with SIRS.
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Danhong
authors.initials: D
authors.lastname: Yang
authors.affiliation: The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
authors.forename: Yuanjun
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Hongying
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Yining
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Yongxi
authors.initials: Y
authors.lastname: Tong
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Meijuan
authors.initials: M
authors.lastname: Chen
keywords: cirrhosis; mortality; prognosisrisk factorsystemic inflammatory response syndrome (SIRS)