1. Determine in-hospital and 28-days mortality rates of critically-ill cirrhotic patients admitted to ICU 2. Evaluate the role of (blood lactate level, lactate/albumin ratio, lactate/bilirubin index and MELD-lactate score) in prediction of mortality compared to other non- lactate containing scores. 3. Study predictors of in-hospital and 28-mortality in these patients.
Liver cirrhosis is a major health problem, which causes high mortality and economic burden worldwide. A large number of liver cirrhosis patients are prone to acute decompensation with organ failure, thus leading them to be admitted to intensive care unit (ICU). Though liver cirrhosis patients have improved outcomes in ICU over the past decade, the prognosis for those patients remains poor, with in-hospital mortality. Assessment of prognosis, especially in patients with cirrhosis at the ICU, is of importance in order to guide therapeutic measures and improve their outcome. Many prognostic scores are used to help predicting complications, expected survival and estimate the risk of various medical interventions in these patients as CTP, MELD, CLIF-C OF, CLIF-C AD and CLIF-C ACLF scores. Although these models are non-invasive, they have certain deficiencies as they don't consider other conditions that are associated with poor prognosis as poor tissue perfusion in critically-ill cirrhotic patients. Lactate is a marker of metabolic changes resulting from tissue hypoxia or stress caused by the release of adrenaline. It was used to improve the prediction of short-term mortality of critically ill patients at ICU. Little is known about role of blood lactate in prediction of prognosis of critically ill Egyptian cirrhotic patients at ICU. Therefore, the investigators will conduct their study to shed some light on this topic.
Study Type
OBSERVATIONAL
Enrollment
50
To determine the hospital and 28-days mortality rates in critically-ill cirrhotic patients admitted to ICU of Al-Rajhy Universty Hospital.
1\) To determine the hospital and 28-days mortality rates in critically-ill cirrhotic patients admitted to the Intensive Care Unit of Al-Rajhy Universty Hospital.
Time frame: within 28 days of patients' admission to the Intensive Care Unit.
To evaluate the role of blood lactate level in prediction of 28-days mortality in critically-ill cirrhotic patients.
Blood lactate level (mmol/L)
Time frame: Blood lactate level will be estimated on the first day of Patients' admission to the ICU.
To evaluate the role of lactate/Albumin ratio in prediction of 28-days mortality in critically-ill cirrhotic patients.
Lactate/Albumin ratio (L/A ratio: albumin in (g/L) compared to lactate (mmol/L)).
Time frame: Lactate/Albumin ratio will be calculated on the first day of Patients' admission to the ICU.
To evaluate the role of lactate/bilirubin index in prediction of 28-days mortality in critically-ill cirrhotic patients.
Lactate bilirubin index ( lactate in mmol/L , bilirubin in umol/l ) : will be calculated as follows : \[1000 × lactate (mmol/L) × bilirubin (µmol/L)\]/2 (Chen et al., 2021).
Time frame: Lactate bilirubin index will be calculated on the first day of Patients' admission to the ICU.
To evaluate the role of MELD-Lactate score in prediction of 28-days mortality in critically-ill cirrhotic patients.
MELD-Lactate score: (Moreau et al., 2013) will be calculated as follows: 0.251 + 5.5257 × sqrt (lactate mmol/L ) + 0.338 × MELD (Sarmast et al., 2020).
Time frame: MELD-Lactate score will be calculated on the first day of Patients' admission to the ICU.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Correlation between blood lactate level and type and number of organ failure.
Correlation between blood lactate level and type and number of organ failure.
Time frame: Within 28 days of Patients' admission to the Intensive Care Unit.
Correlation between blood lactate level and duration of hospital stay.
Correlation between blood lactate level and duration of hospital stay.
Time frame: Within 28 days of Patients' admission to the Intensive Care Unit.