RIFLE classification as predictive factor of mortality in patients with cirrhosis admitted to intensive care unit
Article first published online: 24 SEP 2009
© 2009 The Authors. Journal compilation © 2009 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 24, Issue 10, pages 1639–1647, October 2009
How to Cite
Cholongitas, E., Calvaruso, V., Senzolo, M., Patch, D., Shaw, S., O'Beirne, J. and Burroughs, A. K. (2009), RIFLE classification as predictive factor of mortality in patients with cirrhosis admitted to intensive care unit. Journal of Gastroenterology and Hepatology, 24: 1639–1647. doi: 10.1111/j.1440-1746.2009.05908.x
- Issue published online: 24 SEP 2009
- Article first published online: 24 SEP 2009
- Accepted for publication 31 March 2009.
- intensive care unit;
- renal failure;
Background and Aim: To evaluate the association of the Risk, Injury, Failure, Loss and End-stage renal failure (RIFLE) score on mortality in patients with decompensated cirrhosis admitted to intensive care unit (ICU).
Methods: A cohort of 412 patients with cirrhosis consecutively admitted to ICU was classified according to the RIFLE score. Multivariable logistic regression analysis was used to evaluate the factors associated with mortality. Liver-specific, Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) and RIFLE scores on admission, were compared by receiver–operator characteristic curves.
Results: The overall mortality during ICU stay or within 6 weeks after discharge from ICU was 61.2%, but decreased over time (76% during first interval, 1989–1992 vs 50% during the last, 2005–2006, P < 0.001). Multivariate analysis showed that RIFLE score (odds ratio: 2.1, P < 0.001) was an independent factor significantly associated with mortality. Although SOFA had the best discrimination (area under receiver–operator characteristic curve = 0.84), and the APACHE II had the best calibration, the RIFLE score had the best sensitivity (90%) to predict death in patients during follow up.
Conclusions: RIFLE score was significantly associated with mortality, confirming the importance of renal failure in this large cohort of patients with cirrhosis admitted to ICU, but it is less useful than other scores.