Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.

<h4>Background</h4>Cirrhotic patients with acute kidney injury (AKI) admitted to intensive care units (ICUs) show extremely high mortality rates. We have proposed the MBRS scoring system, which can be used for assessing patients on the day of admission to the ICU; this new system involve...

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Autores principales:	Heng-Chih Pan, Chang-Chyi Jenq, Ming-Hung Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Ming-Yang Chang, Ya-Chung Tian, Cheng-Chieh Hung, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8675801cd7004b3d8fcb897df3d1529b
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spelling	oai:doaj.org-article:8675801cd7004b3d8fcb897df3d1529b2021-11-18T08:06:00ZRisk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.1932-620310.1371/journal.pone.0051094https://doaj.org/article/8675801cd7004b3d8fcb897df3d1529b2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23236437/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Cirrhotic patients with acute kidney injury (AKI) admitted to intensive care units (ICUs) show extremely high mortality rates. We have proposed the MBRS scoring system, which can be used for assessing patients on the day of admission to the ICU; this new system involves determination of mean arterial pressure (MAP) and bilirubin level and assessment of respiratory failure and sepsis. We had used this scoring system to analyze the prognosis of ICU cirrhotic patients with AKI in 2008, and the current study was an external validation of this scoring system.<h4>Methods</h4>A total of 190 cirrhotic patients with AKI were admitted to the ICU between March 2008 and February 2011. We prospectively analyzed and recorded the data for 31 demographic parameters and some clinical characteristic variables on day 1 of admission to the ICU; these variables were considered as predictors of mortality.<h4>Results</h4>The overall in-hospital mortality rate was 73.2% (139/190), and the 6-month mortality rate was 83.2% (158/190). Hepatitis B viral infection (43%) was observed to be the cause of liver disease in most of the patients. Multiple logistic regression analysis indicated that the MBRS and Acute Physiology and Chronic Health Evaluation III (ACPACHE III) scores determined on the first day of admission to the ICU were independent predictors of in-hospital mortality in patients. In the analysis of the area under the receiver operating characteristic (AUROC) curves, the MBRS scores showed good discrimination (AUROC: 0.863±0.032, p<0.001) in predicting in-hospital mortality.<h4>Conclusion</h4>On the basis of the results of this external validation, we conclude that the MBRS scoring system is a reproducible, simple, easy-to-apply evaluation tool that can increase the prediction accuracy of short-term prognosis in critically ill cirrhotic patients with AKI.Heng-Chih PanChang-Chyi JenqMing-Hung TsaiPei-Chun FanChih-Hsiang ChangMing-Yang ChangYa-Chung TianCheng-Chieh HungJi-Tseng FangChih-Wei YangYung-Chang ChenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 12, p e51094 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Heng-Chih Pan Chang-Chyi Jenq Ming-Hung Tsai Pei-Chun Fan Chih-Hsiang Chang Ming-Yang Chang Ya-Chung Tian Cheng-Chieh Hung Ji-Tseng Fang Chih-Wei Yang Yung-Chang Chen Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
description	<h4>Background</h4>Cirrhotic patients with acute kidney injury (AKI) admitted to intensive care units (ICUs) show extremely high mortality rates. We have proposed the MBRS scoring system, which can be used for assessing patients on the day of admission to the ICU; this new system involves determination of mean arterial pressure (MAP) and bilirubin level and assessment of respiratory failure and sepsis. We had used this scoring system to analyze the prognosis of ICU cirrhotic patients with AKI in 2008, and the current study was an external validation of this scoring system.<h4>Methods</h4>A total of 190 cirrhotic patients with AKI were admitted to the ICU between March 2008 and February 2011. We prospectively analyzed and recorded the data for 31 demographic parameters and some clinical characteristic variables on day 1 of admission to the ICU; these variables were considered as predictors of mortality.<h4>Results</h4>The overall in-hospital mortality rate was 73.2% (139/190), and the 6-month mortality rate was 83.2% (158/190). Hepatitis B viral infection (43%) was observed to be the cause of liver disease in most of the patients. Multiple logistic regression analysis indicated that the MBRS and Acute Physiology and Chronic Health Evaluation III (ACPACHE III) scores determined on the first day of admission to the ICU were independent predictors of in-hospital mortality in patients. In the analysis of the area under the receiver operating characteristic (AUROC) curves, the MBRS scores showed good discrimination (AUROC: 0.863±0.032, p<0.001) in predicting in-hospital mortality.<h4>Conclusion</h4>On the basis of the results of this external validation, we conclude that the MBRS scoring system is a reproducible, simple, easy-to-apply evaluation tool that can increase the prediction accuracy of short-term prognosis in critically ill cirrhotic patients with AKI.
format	article
author	Heng-Chih Pan Chang-Chyi Jenq Ming-Hung Tsai Pei-Chun Fan Chih-Hsiang Chang Ming-Yang Chang Ya-Chung Tian Cheng-Chieh Hung Ji-Tseng Fang Chih-Wei Yang Yung-Chang Chen
author_facet	Heng-Chih Pan Chang-Chyi Jenq Ming-Hung Tsai Pei-Chun Fan Chih-Hsiang Chang Ming-Yang Chang Ya-Chung Tian Cheng-Chieh Hung Ji-Tseng Fang Chih-Wei Yang Yung-Chang Chen
author_sort	Heng-Chih Pan
title	Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
title_short	Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
title_full	Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
title_fullStr	Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
title_full_unstemmed	Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
title_sort	risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/8675801cd7004b3d8fcb897df3d1529b
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Risk models and scoring systems for predicting the prognosis in critically ill cirrhotic patients with acute kidney injury: a prospective validation study.

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