Risk Models and Scoring Systems for Predicting the Prognosis in Critically Ill Cirrhotic Patients with Acute Kidney Injury: A Prospective Validation StudyReport as inadecuate




Risk Models and Scoring Systems for Predicting the Prognosis in Critically Ill Cirrhotic Patients with Acute Kidney Injury: A Prospective Validation Study - Download this document for free, or read online. Document in PDF available to download.

Background

Cirrhotic patients with acute kidney injury AKI admitted to intensive care units ICUs show extremely high mortality rates. We have proposed the MBRS scoring system, which can be used for assessing patients on the day of admission to the ICU; this new system involves determination of mean arterial pressure MAP and bilirubin level and assessment of respiratory failure and sepsis. We had used this scoring system to analyze the prognosis of ICU cirrhotic patients with AKI in 2008, and the current study was an external validation of this scoring system.

Methods

A total of 190 cirrhotic patients with AKI were admitted to the ICU between March 2008 and February 2011. We prospectively analyzed and recorded the data for 31 demographic parameters and some clinical characteristic variables on day 1 of admission to the ICU; these variables were considered as predictors of mortality.

Results

The overall in-hospital mortality rate was 73.2% 139-190, and the 6-month mortality rate was 83.2% 158-190. Hepatitis B viral infection 43% was observed to be the cause of liver disease in most of the patients. Multiple logistic regression analysis indicated that the MBRS and Acute Physiology and Chronic Health Evaluation III ACPACHE III scores determined on the first day of admission to the ICU were independent predictors of in-hospital mortality in patients. In the analysis of the area under the receiver operating characteristic AUROC curves, the MBRS scores showed good discrimination AUROC: 0.863±0.032, p<0.001 in predicting in-hospital mortality.

Conclusion

On the basis of the results of this external validation, we conclude that the MBRS scoring system is a reproducible, simple, easy-to-apply evaluation tool that can increase the prediction accuracy of short-term prognosis in critically ill cirrhotic patients with AKI.



Author: Heng-Chih Pan , Chang-Chyi Jenq , Ming-Hung Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Ming-Yang Chang, Ya-Chung Tian, Cheng-Chieh Hu

Source: http://plos.srce.hr/



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