Systemic inflammatory response syndrome in patients with liver cirrhosis.

BACKGROUND AND STUDY AIMS: Patients with liver cirrhosis present an increased susceptibility to the systemic inflammatory response syndrome (SIRS), which is considered the cause of hospital admission in about 10% of patients and is present in about 40% of those admitted for ongoing complications. We tried to assess the prevalence of the SIRS with the possible effects on the course of the disease during hospital stay.

PATIENTS AND METHODS: Two hundred and three patients with liver cirrhosis were examined and investigated with close monitoring during hospital stay. The main clinical endpoints were death and the development of portal hypertension-related complications.

RESULTS: Eighty-one patients met the criteria of SIRS (39.9%). We found significant correlations between SIRS and jaundice (p=0.005), bacterial infection (p=0.008), white blood cell count (p<0.001), low haemoglobin concentration (p=0.004), high serum creatinine levels (p<0.001), high alanine aminotransferase levels (p<0.001), serum bilirubin levels (p<0.001), international normalised ratio (p<0.001), serum albumin levels (p=0.033), high Child-Pugh score (p<0.001). During the follow-up period, 26 patients died (12.8%), 15 developed portal hypertension-related bleeding (7.3%), 30 developed hepatic encephalopathy (14.7%), and 9 developed hepatorenal syndrome type-1 (4.4%). SIRS showed significant correlations both to death (p<0.001) and to portal hypertension-related complications (p<0.001).

CONCLUSION: The systemic inflammatory response syndrome occurs in patients with advanced cirrhosis and is associated with a bad prognosis.