[Systemic inflammatory response syndrome as a prognostic index in cirrhosis]

ABSTRACT

There is some evidence to suggest that the systemic inflammatory response syndrome [SIRS] contributes to the poor outcome of cirrhotic patients. We studied 95 cirrhotic patients admitted to Almouassat and Al-assad University Hospitals assessing prevalence of SIRS and its relationship with short term outcome. Presence of SIRS was assessed on admission and during hospital stay. First end point was death and development of portal hypertension-related complications within their in-hospital stay. Second end point was death within 90 days from admittion, only 60 patients were followed to the second end point. About one-half the patients met SIRS criteria. SIRS was correlated with complications in general [p = 0.003], high serum bilirubin levels [p = 0.008], high international normalized ratio [p = 0.004], low serum albumin [p=0.004], and high model of endstage liver disease [MELD] score [p = 0.0003], During a follow-up of 7 +/- 2 days, 8 patients died [8.4%], 11 developed portal hypertension-related bleeding [11.6%], 26 hepatic encephalopathy [27.4%], and 9 hepatorenal syndrome type-1 [9.5%]. SIRS was correlated both to death [p = 0.03] and to portal hypertension related complications [p = 0.003]. From the patients who were followed to 90 days after admissions; SIRS was significantly correlated to death [p = 0.0005]. SIRS frequently occurs in patients with advanced cirrhosis and is associated with a poor outcome: