Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study
Alassan Kouamé Mahassadi,1 Justine Laure Konang Nguieguia,1 Henriette Ya Kissi,1 Anthony Afum-Adjei Awuah,2 Aboubacar Demba Bangoura,1 Stanislas Adjeka Doffou,1 Alain Koffi Attia1 1Medicine and Hepatogastroenterology Unit, Centre Hospitalier et Universitaire de Yopougon, Abidjan, C&oc...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2018-04-01
|
| Series: | Clinical and Experimental Gastroenterology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/systemic-inflammatory-response-syndrome-and-model-for-end-stage-liver--peer-reviewed-article-CEG |
| _version_ | 1828345035524931584 |
|---|---|
| author | Mahassadi AK Konang Nguieguia JL Kissi HY Afum-Adjei Awuah A Bangoura AD Doffou SA Attia AK |
| author_facet | Mahassadi AK Konang Nguieguia JL Kissi HY Afum-Adjei Awuah A Bangoura AD Doffou SA Attia AK |
| author_sort | Mahassadi AK |
| collection | DOAJ |
| description | Alassan Kouamé Mahassadi,1 Justine Laure Konang Nguieguia,1 Henriette Ya Kissi,1 Anthony Afum-Adjei Awuah,2 Aboubacar Demba Bangoura,1 Stanislas Adjeka Doffou,1 Alain Koffi Attia1 1Medicine and Hepatogastroenterology Unit, Centre Hospitalier et Universitaire de Yopougon, Abidjan, Côte d’Ivoire; 2Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis.Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization.Patients and methods: In this retrospective cohort study, we enrolled 159 patients with cirrhosis (median age: 49 years, 70.4% males). The role of Child–Pugh–Turcotte (CPT) score, MELD score, and SIRS on mortality was determined by the Kaplan–Meier method, and the prognosis factors were assessed with Cox regression model.Results: At initial hospitalization, 74.2%, 20.1%, and 37.7% of the patients with cirrhosis showed the presence of ascites, hepatorenal syndrome, and esophageal varices, respectively. During the in-hospital follow-up, 40 (25.2%) patients died. The overall incidence of mortality was found to be 3.1 [95% confidence interval (CI): 2.2–4.1] per 100 person-days. Survival probabilities were found to be high in case of patients who were SIRS negative (log-rank test= 4.51, p=0.03) and in case of patients with MELD score ≤16 (log-rank test=7.26, p=0.01) compared to the patients who were SIRS positive and those with MELD score >16. Only SIRS (hazard ratio (HR)=3.02, [95% CI: 1.4–7.4], p=0.01) and MELD score >16 (HR=2.2, [95% CI: 1.1–4.3], p=0.02) were independent predictors of mortality in multivariate analysis except CPT, which was not relevant in our study. Patients with MELD score >16 experienced hepatorenal syndrome (p=0.002) and encephalopathy (p=0.001) more frequently than that of patients with MELD score ≤16. SIRS was not useful in predicting complications.Conclusion: MELD score and SIRS can be used as tools for the prediction of mortality in black African patients with decompensated cirrhosis. Keywords: MELD, SIRS, cirrhosis, mortality, Africa |
| first_indexed | 2024-04-14T00:06:43Z |
| format | Article |
| id | doaj.art-64d3e8b9c6ae4a8488aed9bb4df9d1fa |
| institution | Directory Open Access Journal |
| issn | 1178-7023 |
| language | English |
| last_indexed | 2024-04-14T00:06:43Z |
| publishDate | 2018-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical and Experimental Gastroenterology |
| spelling | doaj.art-64d3e8b9c6ae4a8488aed9bb4df9d1fa2022-12-22T02:23:31ZengDove Medical PressClinical and Experimental Gastroenterology1178-70232018-04-01Volume 1114315237638Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort studyMahassadi AKKonang Nguieguia JLKissi HYAfum-Adjei Awuah ABangoura ADDoffou SAAttia AKAlassan Kouamé Mahassadi,1 Justine Laure Konang Nguieguia,1 Henriette Ya Kissi,1 Anthony Afum-Adjei Awuah,2 Aboubacar Demba Bangoura,1 Stanislas Adjeka Doffou,1 Alain Koffi Attia1 1Medicine and Hepatogastroenterology Unit, Centre Hospitalier et Universitaire de Yopougon, Abidjan, Côte d’Ivoire; 2Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis.Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization.Patients and methods: In this retrospective cohort study, we enrolled 159 patients with cirrhosis (median age: 49 years, 70.4% males). The role of Child–Pugh–Turcotte (CPT) score, MELD score, and SIRS on mortality was determined by the Kaplan–Meier method, and the prognosis factors were assessed with Cox regression model.Results: At initial hospitalization, 74.2%, 20.1%, and 37.7% of the patients with cirrhosis showed the presence of ascites, hepatorenal syndrome, and esophageal varices, respectively. During the in-hospital follow-up, 40 (25.2%) patients died. The overall incidence of mortality was found to be 3.1 [95% confidence interval (CI): 2.2–4.1] per 100 person-days. Survival probabilities were found to be high in case of patients who were SIRS negative (log-rank test= 4.51, p=0.03) and in case of patients with MELD score ≤16 (log-rank test=7.26, p=0.01) compared to the patients who were SIRS positive and those with MELD score >16. Only SIRS (hazard ratio (HR)=3.02, [95% CI: 1.4–7.4], p=0.01) and MELD score >16 (HR=2.2, [95% CI: 1.1–4.3], p=0.02) were independent predictors of mortality in multivariate analysis except CPT, which was not relevant in our study. Patients with MELD score >16 experienced hepatorenal syndrome (p=0.002) and encephalopathy (p=0.001) more frequently than that of patients with MELD score ≤16. SIRS was not useful in predicting complications.Conclusion: MELD score and SIRS can be used as tools for the prediction of mortality in black African patients with decompensated cirrhosis. Keywords: MELD, SIRS, cirrhosis, mortality, Africahttps://www.dovepress.com/systemic-inflammatory-response-syndrome-and-model-for-end-stage-liver--peer-reviewed-article-CEGMELDSIRScirrhosismortalityAfrica |
| spellingShingle | Mahassadi AK Konang Nguieguia JL Kissi HY Afum-Adjei Awuah A Bangoura AD Doffou SA Attia AK Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study Clinical and Experimental Gastroenterology MELD SIRS cirrhosis mortality Africa |
| title | Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study |
| title_full | Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study |
| title_fullStr | Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study |
| title_full_unstemmed | Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study |
| title_short | Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study |
| title_sort | systemic inflammatory response syndrome and model for end stage liver disease score accurately predict the in hospital mortality of black african patients with decompensated cirrhosis at initial hospitalization a retrospective cohort study |
| topic | MELD SIRS cirrhosis mortality Africa |
| url | https://www.dovepress.com/systemic-inflammatory-response-syndrome-and-model-for-end-stage-liver--peer-reviewed-article-CEG |
| work_keys_str_mv | AT mahassadiak systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy AT konangnguieguiajl systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy AT kissihy systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy AT afumadjeiawuaha systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy AT bangouraad systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy AT doffousa systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy AT attiaak systemicinflammatoryresponsesyndromeandmodelforendstageliverdiseasescoreaccuratelypredicttheinhospitalmortalityofblackafricanpatientswithdecompensatedcirrhosisatinitialhospitalizationaretrospectivecohortstudy |