Survival prediction using the Freiburg index of post-TIPS survival (FIPS) in critically ill patients with acute- on chronic liver failure: A retrospective observational study.
acute-on-chronic liver failure
intensive and critical care
liver cirrhosis
portal hypertension
prognosis
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
12
09
2022
accepted:
05
12
2022
entrez:
9
1
2023
pubmed:
10
1
2023
medline:
10
1
2023
Statut:
epublish
Résumé
Liver cirrhosis in patients treated in the intensive care unit (ICU) is associated with high mortality. Well established scores are useful to allow for assessment of prognosis and support ICU treatment guidance. However, currently used scoring systems often do not reflect the complexity of critically ill patients. Therefore, we tested the newly developed Freiburg index-of post-TIPS survival (FIPS) score in order to assess its potential role for prognostication of cirrhotic patients in the ICU. A total of 310 patients with liver cirrhosis treated in the ICU between 2010 and 2021 were enrolled in this retrospective observational study. Prognostic factors for mortality and 28-day mortality were assessed. Moreover, using c indices the prognostic discrimination of different prognostic scores was analyzed. The FIPS score allowed to discriminate patients with high ICU mortality and within 28-days after ICU treatment (ICU mortality: 42.2 vs. 59.9%, Similar to other commonly used scores, the FIPS score in its current composition does not allow a sufficiently reliable prognostication of critically ill patients treated in the ICU. However, adding lactate as additional factor to the FIPS score may improve its prognostic ability.
Sections du résumé
Background and aim
UNASSIGNED
Liver cirrhosis in patients treated in the intensive care unit (ICU) is associated with high mortality. Well established scores are useful to allow for assessment of prognosis and support ICU treatment guidance. However, currently used scoring systems often do not reflect the complexity of critically ill patients. Therefore, we tested the newly developed Freiburg index-of post-TIPS survival (FIPS) score in order to assess its potential role for prognostication of cirrhotic patients in the ICU.
Methods
UNASSIGNED
A total of 310 patients with liver cirrhosis treated in the ICU between 2010 and 2021 were enrolled in this retrospective observational study. Prognostic factors for mortality and 28-day mortality were assessed. Moreover, using c indices the prognostic discrimination of different prognostic scores was analyzed.
Results
UNASSIGNED
The FIPS score allowed to discriminate patients with high ICU mortality and within 28-days after ICU treatment (ICU mortality: 42.2 vs. 59.9%,
Conclusion
UNASSIGNED
Similar to other commonly used scores, the FIPS score in its current composition does not allow a sufficiently reliable prognostication of critically ill patients treated in the ICU. However, adding lactate as additional factor to the FIPS score may improve its prognostic ability.
Identifiants
pubmed: 36619640
doi: 10.3389/fmed.2022.1042674
pmc: PMC9812953
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1042674Informations de copyright
Copyright © 2022 Luxenburger, Schmidt, Biever, Supady, Sekandarzad, Roehlen, Reincke, Neumann-Haefelin, Schultheiss, Wengenmayer, Thimme and Bettinger.
Déclaration de conflit d'intérêts
DB: Consultant Bayer Healthcare, Boston Scientific, and Shionogi. Lectures: Falk Foundation and W. L. Gore & Associates. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Gastroenterology. 2013 Jun;144(7):1426-37, 1437.e1-9
pubmed: 23474284
Gut. 2017 Mar;66(3):541-553
pubmed: 28053053
Visc Med. 2018 Aug;34(4):254-258
pubmed: 30345282
J Hepatol. 2018 Aug;69(2):406-460
pubmed: 29653741
Liver Int. 2023 Jan;43(1):180-193
pubmed: 35727853
Intern Emerg Med. 2021 Jan;16(1):115-123
pubmed: 32415561
Hepatology. 2019 Apr;69(4):1686-1701
pubmed: 30521097
J Hepatol. 2014 Nov;61(5):1038-47
pubmed: 24950482
PLoS One. 2013;8(1):e51926
pubmed: 23349678
Dig Dis Sci. 2022 Sep;67(9):4581-4589
pubmed: 34797445
J Clin Gastroenterol. 2018 Nov/Dec;52(10):913-917
pubmed: 29356783
Br J Surg. 1973 Aug;60(8):646-9
pubmed: 4541913
J Hepatol. 2014 Mar;60(3):570-8
pubmed: 24280294
J Crit Care. 2017 Dec;42:200-205
pubmed: 28772222
Hepatology. 2007 Mar;45(3):797-805
pubmed: 17326206
Hepatology. 2022 Aug 3;:
pubmed: 35921493
J Hepatol. 2021 Jun;74(6):1362-1372
pubmed: 33508376
J Hepatol. 2015 Apr;62(4):831-40
pubmed: 25463539
Hepatology. 2016 Oct;64(4):1249-64
pubmed: 27483394
Clin Gastroenterol Hepatol. 2020 Apr;18(4):963-973.e14
pubmed: 31394283
Hepatology. 2019 Jan;69(1):258-269
pubmed: 30070381
J Hepatol. 2021 Aug;75(2):487-489
pubmed: 33716088
Nat Rev Dis Primers. 2016 Jun 09;2:16041
pubmed: 27277335
Crit Care Med. 2010 Nov;38(11):2108-16
pubmed: 20802324
Ann Surg. 2003 Mar;237(3):319-34
pubmed: 12616115
J Hepatol. 2015 Apr;62(1 Suppl):S131-43
pubmed: 25920082
Intensive Care Med. 2016 Feb;42(2):202-10
pubmed: 26556617
Eur J Gastroenterol Hepatol. 2022 Oct 1;34(10):1074-1080
pubmed: 36062497
N Engl J Med. 2008 Sep 4;359(10):1018-26
pubmed: 18768945
PLoS Med. 2007 Oct 16;4(10):e297
pubmed: 17941715
Liver Transpl. 2021 Feb;27(2):177-189
pubmed: 33025731