SIRS criteria versus qSOFA score in patients with severe alcohol-related hepatitis.

Autor: Pérez-Hernández O; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., de la Paz-Estrello AM; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Fernández-Alonso P; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Martín-Navarro LG; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Fernández-Rodríguez C; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Durán-Castellón MDC; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., Vera-Delgado VE; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain., González-Reimers E; Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, Spain., Martín-González C; Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain. mmartgon@ull.edu.es.; Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, Spain. mmartgon@ull.edu.es.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2024 Oct 11. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1007/s11739-024-03786-2
Abstrakt: Severe alcohol-related hepatitis (sAH) is a potentially life-threatening complication of alcohol-related liver disease. SIRS criteria have been related to disease severity and may be a prognostic factor. Recently, qSOFA has been shown to be more prognostically accurate than SIRS in other inflammatory conditions. To determine whether qSOFA is a better prognostic score than SIRS criteria in sAH. We included 62 consecutive patients admitted for sAH, defined by modified Maddrey DF ≥ 32. MELD-Na, SIRS criteria and qSOFA score were calculated. Survival at 180 days was assessed. Twenty-four patients (38.7%) died after 180 days. Three or more SIRS criteria and two or more qSOFA criteria were associated with 180-day mortality (LR = 12.09, p = 0.001; LR = 4.81, p = 0.028, respectively). Patients with MELD-Na >30 points died during follow-up more frequently (LR = 5.997; p = 0.014). SIRS respiratory criterion (B = 5.113; p = 0.023) and qSOFA respiratory criterion (B = 5.985; p = 0.05), bilirubin (>10 mg/dL; LR = 5.43, p = 0.006), creatinine (>1 mg/dL; B = 5.885, p = 0.015) and hyponatraemia (LR= 5.75, p = 0.018) were associated with mortality. Cox Regression model revealed that only SIRS and MELD-Na were independent prognostic factors. SIRS criteria seem to be more useful for patients with sAH, as well as MELD-Na. In contrast, qSOFA has no independent prognostic value in patients with sAH.
(© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
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