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논문 기본 정보

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학술저널
저자정보
Ji Hyun Kim (Department of Internal Medicine Kangwon National University School of Medicine) Baek Gyu Jun (Department of Internal Medicine Sanggye Paik Hospital Inje University College of Medicine) Minjong Lee (Department of Internal Medicine Ewha Womans University Medical Center) Hye Ah Lee (Clinical Trial Center Ewha Womans University Seoul Hospital) Tae Suk Kim (Department of Internal Medicine Kangwon National University School of Medicine) Jeongwon Heo (Department of Internal Medicine Kangwon National University School of Medicine) Da Hye Moon (Department of Internal Medicine Kangwon National University School of Medicine) Seong Hee Kang (Department of Internal Medicine Sanggye Paik Hospital Inje University College of Medicine) Ki Tae Suk (Department of Internal Medicine Chuncheon Sacred Heart Hospital) Moon Young Kim (Department of Internal Medicine Wonju Severance Christian Hospital) Young Don Kim (Department of Internal Medicine Gangneung Asan Hospital University of Ulsan College of Medicine) Gab Jin Cheon (Department of Internal Medicine Gangneung Asan Hospital University of Ulsan College of Medicine) Soon Koo Baik (Department of Internal Medicine Wonju Severance Christian Hospital) Dong Joon Kim (Department of Internal Medicine Chuncheon Sacred Heart Hospital) Dae Hee Choi (Department of Internal Medicine Kangwon National University School of Medicine)
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제28권 제3호
발행연도
2022.7
수록면
540 - 552 (13page)
DOI
10.3350/cmh.2021.0169

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Background/Aims: Sepsis-3 criteria and quick Sequential Organ Failure Assessment (qSOFA) have been advocated to be used in defining sepsis in the general population. We aimed to compare the Sepsis-3 criteria and Chronic Liver Failure-SOFA (CLIF-SOFA) scores as predictors of in-hospital mortality in cirrhotic patients admitted to the emergency department (ED) for infections. Methods: A total of 1,622 cirrhosis patients admitted at the ED for infections were assessed retrospectively. We analyzed their demographic, laboratory, and microbiological data upon diagnosis of the infection. The primary endpoint was inhospital mortality rate. The predictive performances of baseline CLIF-SOFA, Sepsis-3, and qSOFA scores for in-hospital mortality were evaluated. Results: The CLIF-SOFA score proved to be significantly better in predicting in-hospital mortality (area under the receiver operating characteristic curve [AUROC], 0.80; 95% confidence interval [CI], 0.78?0.82) than the Sepsis-3 (AUROC, 0.75; 95% CI, 0.72?0.77, P<0.001) and qSOFA (AUROC, 0.67; 95% CI, 0.64?0.70; P<0.001) score. The CLIF-SOFA, CLIF-C-AD scores, Sepsis-3 criteria, septic shock, and qSOFA positivity were significantly associated with in-hospital mortality (adjusted hazard ratio [aHR], 1.24; 95% CI, 1.19?1.28; aHR, 1.13; 95% CI, 1.09?1.17; aHR, 1.19; 95% CI, 1.15?1.24; aHR, 1.88; 95% CI, 1.42?2.48; aHR, 2.06; 95% CI, 1.55?2.72; respectively; all P<0.001). For CLIF-SOFA scores ≥6, in-hospital mortality was >10%; this is the cutoff point for the definition of sepsis. Conclusions: Among cirrhosis patients presenting with infections at the ED, CLIF-SOFA scores showed a better predictive performance for mortality than both Sepsis-3 criteria and qSOFA scores, and can be a useful tool of risk stratification in cirrhotic patients requiring timely intervention for infection.

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