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The online version of this article (doi:10.1186/1471-2253-14-123) contains supplementary material, which is available to authorized users.
Chung-Ming Fu, Chih-Hsiang Chang contributed equally to this work.
The authors declare that they have no competing interests.
CMF drafted the manuscript. CHC revised the manuscript and conducted the statistical analysis. PCF conducted the statistical analysis. MHT, SML and KCK helped with acquisition and interpretation of data. YCT and CCH helped with data analysis and interpretation. JTF and CWY participated in the design of the study. YCC conceived of this study and was responsible for coordination. All authors critically revised the manuscript. All authors have seen and approved the final draft of the manuscript.
Cirrhotic patients admitted to an intensive care unit (ICU) have high mortality rates. The present study compared the characteristics and outcomes of critically ill patients admitted to the ICU with and without cirrhosis using the matched Acute Physiology and Chronic Health Evaluation III (APACHE III) and Sequential Organ Failure Assessment (SOFA) scores.
A retrospective case-control study was performed at the medical ICU of a tertiary-care hospital between January 2006 and December 2009. Patients were admitted with life-threatening complications and were matched for APACHE III and SOFA scores. Of 336 patients enrolled in the study, 87 in the cirrhosis or noncirrhosis group were matched according to the APACHE III scores. Another 55 patients with cirrhosis were matched to the 55 patients without cirrhosis according to the SOFA scores. Demographic data, aetiology of ICU admission, and laboratory variables were also evaluated.
The overall hospital mortality rate in the patients with cirrhosis in the APACHE III-matched group was more than that in their counterparts (73.6% vs 57.5%, P = .026) but the rate did not differ significantly in the SOFA-matched group (61.8% vs 67.3%). In the APACHE III-matched group, the SOFA scores of patients with cirrhosis were significantly higher than those of patients without cirrhosis (P < .001), whereas the difference in APACHE III scores was nonsignificant between the SOFA-matched patients with and without cirrhosis.
Score-matched analytical data showed that the SOFA scores significantly differentiated the patients admitted to the ICU with cirrhosis from those without cirrhosis in APACHE III-matched groups, whereas difference in the APACHE III scores between the patients with and without cirrhosis were nonsignificant in the SOFA-matched group.