Systemic inflammatory response syndrome as prognostic indicator in hospitalized cirrhotic patients

The systemic inflammation worsens circulatory disorders in cirrhotic patients and recently the systemic inflammatory response syndrome (SIRS) may be a prognostic indicator therein. The aim of the study was to determine whether the presence of SIRS at admission in hospitalized cirrhotic patients is associated with complications or mortality. A retrospective cohorts study was conducted at the Daniel Alcides Carrion National Hospital.Hospitalized cirrhotic patients admitted from July 2008 to December 2010 without significant comorbidities, malignancy,HIV infection, or stay less than 72 hours were included. Presence of SIRS at admission and the occurrence of complications or death after 72 hours of admission were evaluated. 150 cirrhotic patients were admitted, six were excluded;three for lower survival at 72 hours, one for neoplasia, one for severe heart failure and two for chronic renal failure. One hundred forty four patients were included, 95 (66%) patients had SIRS at admission. There was no significant difference in age, sex, etiology, in both groups. SIRS was associated with higher scores of MELD and Child-Turcotte Pugh. Of the group of patients with SIRS, 41 (43%) had complications and 16 (16.8%) died, while the group without SIRS 5 (10.2%) had complications and two (4%) died p < 0.0001 and p=0.028 respectively. The most common complications were infections and hepatic encephalopathy. In multivariate analysis SIRS was associated with complications (p < 0.006) but not with mortality(p < 0.276). SIRS is common in hospitalized cirrhotic patients and is associated with in-hospital complications.