The association of systemic inflammatory response syndrome with 30-day mortality in critically ill cirrhosis patients with acute kidney injury: An analysis of the Medical Information Mart for Intensive Care-IV database.

ObjectivesTo evaluate the association between systemic inflammatory response syndrome (SIRS) and 30-day mortality in critically ill cirrhosis patients with acute kidney injury (AKI).MethodsThis retrospective cohort study utilized the Medical Information Mart for Intensive Care-IV database. Multivariable Cox proportional hazard regression, with covariates selected by Least Absolute Shrinkage and Selection Operator regression, was employed to assess the association. Model performance was evaluated with the Brier score, and the additive predictive value of SIRS to the model for end-stage liver disease (MELD) and sequential organ failure assessment (SOFA) scores was compared using the DeLong test.ResultsAmong the 1797 enrolled patients, the 30-day mortality rate was 38.23% (n = 687). A higher SIRS was independently associated with increased 30-day mortality (adjusted hazard ratio: 1.31; 95% confidence interval: 1.20-1.43). This association remained consistent across subgroups stratified by age, gender, albumin infusion, sepsis, AKI stage, and etiology (all p < 0.05). The predictive performance for mortality was significantly improved when SIRS was combined with MELD or SOFA scores compared to each score alone [areas under the curve: SIRS + MELD vs. MELD, 0.711 vs. 0.697; SIRS + SOFA vs. SOFA, 0.635 vs. 0.617].ConclusionAn elevated SIRS score was associated with a higher risk of short-term mortality in critically ill cirrhosis patients with AKI. As an easily obtainable bedside metric, SIRS represents a valuable tool for identifying high-risk patients, potentially enabling timely clinical interventions.