Reappraisal of sepsis-3 and CLIF-SOFA as predictors of mortality in patients with cirrhosis and infection presenting to the emergency department: A multicenter study

Autor: Ji Hyun Kim, Baek Gyu Jun, Minjong Lee, Hye Ah Lee, Tae Suk Kim, Jeong Won Heo, Da Hye Moon, Seong Hee Kang, Ki Tae Suk, Moon Young Kim, Young Don Kim, Gab Jin Cheon, Soon Koo Baik, Dong Joon Kim, Dae Hee Choi
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Clinical and Molecular Hepatology, Vol 28, Iss 3, Pp 540-552 (2022)
Druh dokumentu: article
ISSN: 2287-2728
2287-285X
DOI: 10.3350/cmh.2021.0169
Popis: Background/Aims Sepsis-3 criteria and quick Sequential Organ Failure Assessment (qSOFA) have been advocated to be used in defining sepsis in the general population. We aimed to compare the Sepsis-3 criteria and Chronic Liver Failure-SOFA (CLIF-SOFA) scores as predictors of in-hospital mortality in cirrhotic patients admitted to the emergency department (ED) for infections. Methods A total of 1,622 cirrhosis patients admitted at the ED for infections were assessed retrospectively. We analyzed their demographic, laboratory, and microbiological data upon diagnosis of the infection. The primary endpoint was inhospital mortality rate. The predictive performances of baseline CLIF-SOFA, Sepsis-3, and qSOFA scores for in-hospital mortality were evaluated. Results The CLIF-SOFA score proved to be significantly better in predicting in-hospital mortality (area under the receiver operating characteristic curve [AUROC], 0.80; 95% confidence interval [CI], 0.78–0.82) than the Sepsis-3 (AUROC, 0.75; 95% CI, 0.72–0.77, P10%; this is the cutoff point for the definition of sepsis. Conclusions Among cirrhosis patients presenting with infections at the ED, CLIF-SOFA scores showed a better predictive performance for mortality than both Sepsis-3 criteria and qSOFA scores, and can be a useful tool of risk stratification in cirrhotic patients requiring timely intervention for infection.
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