Intensive care unit admission of decompensated cirrhotic patients: prognostic scoring systems.

摘要: Cirrhotic patients who need critical care support show high morbidity and mortality rates compared with other critically ill patients. Their prognosis is, in fact, influenced by both the severity of underlying hepatic disease worsening extrahepatic organ function. Clinicians investigators have been persistently looking for objective scoring systems capable providing accurate information on short-term prognosis. Risk stratification helps differentiate would not benefit from admission to intensive unit (ICU) those could achieve better outcomes once aggressively treated. The most common scores, ie, multiple dysfunction score, sequential failure assessment, acute physiology chronic health evaluation, developed general ICUs evaluate illness severity, also validated predict cirrhotic admitted ICU. However, their absolute predictive value has questioned. A weakness prediction models consists recognizing continuum physiological changes decompensated In addition, power stratify individual risk is relatively low due great variability liver stages, related manifestations, number nonfunctioning organs admission. Probability are predicting whether a patient will live or die 100% accuracy, nor can they deny confirm indications mechanical ventilation, vasopressor renal replacement therapy, help decide when withhold withdraw support. Because there no criteria which improve normalization function deteriorate progressively, system should be regarded as an adjunct rather than substitute clinical judgment decision process concerning