응급실에서 중증 간경화 합병증 환자의 조기 예후 평가 = Prognostic Assessment in Critical Ill Prognostic Assessment in Critical Ill Patients with Complications of Liver Cirrhosis Presenting to Emergency Department

다국어 초록 (Multilingual Abstract)

P u r p o s e: Many patients with cirrhotic complications have
been visiting the emergency department (ED). The severity
of the malady and the prognosis for the patient are influenced
by the degree of hepatic dysfunction. This study was
performed to evaluate the prognostic factors for predicting
hospital mortality in patients with cirrhosis by comparing the
Sequential Organ Failure Assessment (SOFA) score system,
the acute physiology and chronic health evaluation
(APACHE) II score system, and the modified child-pugh
classification score system in the ED.
M e t h o d s: We retrospectively analyzed the medical records
of 106 patients with cirrhotic complications who were admitted
to the ED of Chungbuk National University Hospital during
a 12-month period from June 1, 2003 to May 31, 2003.
We classified the complications of cirrhosis as hepatic
encephalopathy, upper gastrointestinal bleeding due to
varix rupture, and spontaneous bacterial peritonitis.
Collected data included the patient’s age and gender, the
duration of hosptial stay, the vital signs, the SOFA score,
the APACHE II score, and the Modified Child-Pugh classification
score at the time of admission to the ED.
R e s u l t s: The overall predictive accuracy of the SOFA was
5.5% and 10.5% greater than that of the Modified childpugh
classification score system and the APACHE II,
respectively. By using the area under receiver operating
characteristic (AUROC) curves, the SOFA showed an
excellent discriminative power (AUROC 0.875) and the
Modified Child-Pugh classification score system (AUROC
0.778) and the APACHE II (AUROC 0.763).
C o n c l u s i o n s: The SOFA is an easily applied tool with
excellent prognostic abilities and can be used to enhance
clinical determination of a prognosis and to provide patients
and their families with objective information.

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