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The systemic inflammatory response syndrome in acute liver failure
1Institute of Liver Studies, Guy's King's & St Thomas' Medical School, London, UK. nancy.rolando@btinternet.com
Hepatology (Baltimore, Md.)
|September 26, 2000
Summary
Systemic inflammatory response syndrome (SIRS) in acute liver failure (ALF) is common and linked to worse outcomes. SIRS, with or without infection, worsens encephalopathy and prognosis in ALF patients.
Area of Science:
- Hepatology
- Critical Care Medicine
- Infectious Diseases
Background:
- Systemic inflammatory response syndrome (SIRS) is common in acute liver failure (ALF), often associated with infection.
- The impact of SIRS on ALF progression and outcomes, particularly concerning infection, remains understudied.
Purpose of the Study:
- To investigate the prevalence and impact of SIRS in ALF patients.
- To determine the relationship between SIRS, infection, encephalopathy, and mortality in ALF.
Main Methods:
- Retrospective analysis of 887 ALF patients over 11 years.
- Recording of SIRS components on admission and during infection episodes.
- Correlation of SIRS magnitude with infection type, encephalopathy, and mortality.
Main Results:
- Over 56% of ALF patients developed SIRS; 40% without infection showed worse outcomes.
- Infected patients had higher SIRS incidence and magnitude.
- SIRS magnitude correlated significantly with mortality in bacterial infections, severe sepsis, and septic shock.
- SIRS and infection were associated with progressive encephalopathy.
Conclusions:
- SIRS in ALF, irrespective of infection, contributes to encephalopathy progression.
- SIRS is a significant predictor of poor prognosis and reduced transplant eligibility in ALF.
- Early recognition and management of SIRS in ALF are crucial for improving patient outcomes.