Portal de Periódicos da CAPES

166 Glucose metabolism in living-donor liver transplantation correlates with liver function and IGF-1

2006; Elsevier BV; Volume: 44; Linguagem: Inglês

10.1016/s0168-8278(06)80167-4

1600-0641

Martin Stockmann, S. Nolting, T. Konrade, D. Hiinerbein, H. Döbling, P. Neuhaus,

Organ Transplantation Techniques and Outcomes

POSTERSintensive care medicine as predictors of in-hospital mortality in patients with ACLE Methods: Consecutive patients fulfilling diagnostic criteria for ACLF admitted to the medical ICU between 1995 and 2005 were analyzed retrospectively.Clinical and laboratory parameters were recorded from the charts at admission (day 0) and at day 3 to calculate the Child@ugh score (CPS), the Model for End-Stage Liver Disease (MELD), the Acute Physiology and Chronic Health Evaluation (APACHE) II score, and the Sequential Organ Failure Assessment (SOFA) score.The primary endpoint was in-hospital mortality.To assess diagnostic accuracy of each score, receiver operating characteric (ROC) curves were constructed and areas under the ROC curves (AUROC) were calculated.Results: Seventy-one patients (42 male, 29 female, age 55• years) were identified.In-hospital mortality was 66% (47/71).None of the prognostic scores could predict mortality when calculated at admission (day 0).The APACHE II and SOFA scores at day 3 (AUROC 0.69 and 0.68, respectively) as well as their improvement over the first three days (AUROC 0.73 and 0.74, respectively) showed significant diagnostic accuracies for prediction of mortality.At day 3, an APACHE II score >23 (PPV 84%) or a SOFA score >13 (PPV 83%) could reliably predict mortality.In contrast, neither the CPS nor the MELD was predictive of mortality at any time-point. Conclusions:In patients with ACLF admitted to a medical ICU, global prognostic scores (APACHE II, SOFA) were superior to specific scores of liver dysfunction (CPS, MELD) for estimation of prognosis.These findings indicate that short-term survival in patients with ACLF is mainly determined by end-organ failure.