EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease
Acute-on-chronic liver failure (ACLF) is associated with high mortality. Objective prognostic scores are important for treatment decisions. EASIX (Endothelial Activation and Stress Index) is a simple biomarker consisting of LDH, platelets, and creatinine, reflecting endothelial dysfunction after all...
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/7/2553 |
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| author | David Schult Sebastian Rasch Roland M. Schmid Tobias Lahmer Ulrich Mayr |
| author_facet | David Schult Sebastian Rasch Roland M. Schmid Tobias Lahmer Ulrich Mayr |
| author_sort | David Schult |
| collection | DOAJ |
| description | Acute-on-chronic liver failure (ACLF) is associated with high mortality. Objective prognostic scores are important for treatment decisions. EASIX (Endothelial Activation and Stress Index) is a simple biomarker consisting of LDH, platelets, and creatinine, reflecting endothelial dysfunction after allogeneic stem cell transplantation. Considering endothelial dysfunction in the pathogenesis of ACLF, this study aimed to test the discriminative ability of EASIX in advanced liver disease. We retrospectively analysed the prognostic potential of EASIX to predict 28-day and 3-month mortality in a total of 188 liver cirrhotic patients requiring treatment at the intensive care unit. We evaluated the ability of EASIX to rule out early infections and predict the need for hemodialysis. EASIX performed moderately better than established scores in predicting 28-day mortality (AUC = 0.771) and was nearly equivalent (AUC = 0.791) to SOFA and APACHE-II in the prediction of 3-month mortality. Importantly, EASIX showed better diagnostic potential in ruling out clinically apparent infections than common proinflammatory markers (AUC = 0.861, <i>p</i> < 0.001) and showed suitable accuracy in predicting the need for hemodialysis (AUC = 0.833). EASIX is an accurate, objective and easily assessable biomarker for predicting mortality and complications in patients with advanced liver disease. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:32:45Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-5ed59ba4e67e466e9a077bf264ca83ff2023-11-17T16:58:46ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01127255310.3390/jcm12072553EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver DiseaseDavid Schult0Sebastian Rasch1Roland M. Schmid2Tobias Lahmer3Ulrich Mayr4Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675 München, GermanyAcute-on-chronic liver failure (ACLF) is associated with high mortality. Objective prognostic scores are important for treatment decisions. EASIX (Endothelial Activation and Stress Index) is a simple biomarker consisting of LDH, platelets, and creatinine, reflecting endothelial dysfunction after allogeneic stem cell transplantation. Considering endothelial dysfunction in the pathogenesis of ACLF, this study aimed to test the discriminative ability of EASIX in advanced liver disease. We retrospectively analysed the prognostic potential of EASIX to predict 28-day and 3-month mortality in a total of 188 liver cirrhotic patients requiring treatment at the intensive care unit. We evaluated the ability of EASIX to rule out early infections and predict the need for hemodialysis. EASIX performed moderately better than established scores in predicting 28-day mortality (AUC = 0.771) and was nearly equivalent (AUC = 0.791) to SOFA and APACHE-II in the prediction of 3-month mortality. Importantly, EASIX showed better diagnostic potential in ruling out clinically apparent infections than common proinflammatory markers (AUC = 0.861, <i>p</i> < 0.001) and showed suitable accuracy in predicting the need for hemodialysis (AUC = 0.833). EASIX is an accurate, objective and easily assessable biomarker for predicting mortality and complications in patients with advanced liver disease.https://www.mdpi.com/2077-0383/12/7/2553EASIXliver cirrhosisacute-on-chronic liver failureendothelial dysfunctionintensive care unit |
| spellingShingle | David Schult Sebastian Rasch Roland M. Schmid Tobias Lahmer Ulrich Mayr EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease Journal of Clinical Medicine EASIX liver cirrhosis acute-on-chronic liver failure endothelial dysfunction intensive care unit |
| title | EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease |
| title_full | EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease |
| title_fullStr | EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease |
| title_full_unstemmed | EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease |
| title_short | EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease |
| title_sort | easix is an accurate and easily available prognostic score in critically ill patients with advanced liver disease |
| topic | EASIX liver cirrhosis acute-on-chronic liver failure endothelial dysfunction intensive care unit |
| url | https://www.mdpi.com/2077-0383/12/7/2553 |
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