The Clinical Course Of Cirrhosis Patients Hospitalized For Acute Hepatic Deterioration

Aims:Patients with hepatic cirrhosis often suffer from acute hepatic function impairment, and are likely to develop acute hepatic failure. This study is aimed to describe the clinical procedure of hepatic cirrhosis with acute hepatic deterioration.Methods:This is a prospective study, and 163 patients with hepatic cirrhosis and acute hepatic deterioration were included. Organ function failure, Systemic Inflammatory Response Syndrome (SIRS) and infection during Hospital stay were recorded. And the relationship between organ function failure and death, SIRS or infection was analyzed.Results:35 of the 163 patients didn’t develop any organ function failure during hospital stay (90-day mortality rate:0%).84 patients developed intra-hepatic organ function failure which is defined as liver and/or coagulation failure (90-day mortality rate: 22.6%).44 patients developed extra-hepatic organ function failures which is defined as kidney, cerebral, circulation, and respiratory failure, on the basis of intra-hepatic organ function failure (90-day mortality rate:90.9%). Multivariable analysis shows that age, white blood cell, occurrence of intra-hepatic and extra-hepatic organ function failure are all predictive factors of 90-day death. A logistic regression analysis declares that SIRS are associated with extra-hepatic organ function failure. Further more, intra-hepatic organ function failure at admission and infection during hospital stay are also potential risk factors.Conclusion:The clinical course of hepatic cirrhosis with acute hepatic deterioration can be divided into 3 consecutive stages (acute hepatic deterioration, intra-hepatic organ function failure, extra-hepatic organ function failure). PIRO criteria provide perfect prognostication of these patients. And SIRS may be a target of blocking the development of extra-hepatic organ failure.