Risk factors for mortality in cirrhotic patients with sepsis

Area of Science:

• Hepatology
• Infectious Diseases
• Critical Care Medicine

Background:

• Cirrhosis is a significant risk factor for increased mortality in patients with sepsis.
• Identifying predictors of mortality is crucial for managing these high-risk patients.

Purpose of the Study:

• To determine factors associated with increased in-hospital mortality in cirrhotic patients admitted for sepsis.
• To identify specific clinical and laboratory markers that predict adverse outcomes.

Main Methods:

• Retrospective analysis of cirrhotic patients admitted with sepsis between 2004 and 2007.
• Inclusion criteria: liver cirrhosis and sepsis (defined by infection source and inflammatory markers).
• Data collected: baseline characteristics, investigations, infection details, and in-hospital mortality.

Main Results:

• In-hospital mortality rate was 24.4% among 205 admissions.
• Child-Pugh score (≥10) and Model for End-Stage Liver Disease (MELD) score (≥17) were significant predictors.
• Multivariate analysis identified >1 infection site, pneumonia, Child's C status, and MELD score ≥17 as mortality predictors.
• Mortality increased progressively with the number of risk factors present, from 0% with none to 100% with four.

Conclusions:

• Septic cirrhotic patients with pneumonia, multiple infection sites, Child's C cirrhosis, and high MELD scores face a substantially elevated mortality risk.
• These findings highlight the need for aggressive management and risk stratification in this vulnerable population.