Alcoholic Liver Disease and Systemic Inflammatory Response Syndrome: Mortality Prediction Using Biomarkers and Clinical Scores.

Background/

Objectives

Cirrhosis is an irreversible state of chronic liver disease. Systemic inflammatory response syndrome (SIRS) is a severe complication and significantly contributes to lethal outcomes in cirrhotic patients. We studied a group of cirrhotic patients with SIRS admitted to our centre, assessing the relationship with in-hospital outcomes.

Methods

The study population included 102 patients with alcoholic cirrhosis and SIRS. Laboratory biomarkers, the model for end-stage liver disease, the model for end-stage liver disease-natrium, the Acute Physiology and Chronic Health Evaluation II score, CLIF-C organ failure, the systemic immune-inflammation index score (S II), and the Cirrhosis Acute Gastrointestinal Bleeding (CAGIB) score were tested in relation to the mortality risk using receiver operating characteristic (ROC) curves.

Results

Our results demonstrated that values of sodium, chlorides, and albumin significantly correlated with 7-day survival. The area under the curve's (AUCs) values for sodium, chlorides, and albumin were 0.542, 0.627, and 0.610, respectively, for 7-day mortality prediction. The CAGIB score significantly correlated with 7-day mortality, with the cut-off value of -7.86 (AUC: 0.674, 95% CI (0.555-0.794)). For the assessment of 28-day mortality, the AUC values for sodium, chlorides, and albumin were 0.630, 0.654, and 0.661, respectively. Additionally, the cut-off value of the CAGIB score was found to be -7.84 (AUC: 0.625, 95% CI (0.509-0.740)) in 28-day mortality prediction.

Conclusions

Sodium, chlorides, albumin, and the CAGIB score are reliable predictors of 7-day and 28-day in-hospital mortality in patients with advanced alcoholic liver disease and SIRS.