頁籤選單縮合
題 名 | Sequential Organ Failure Assessment Score Predicts 3-Month Mortality after Molecular Adsorbent Recirculating System Dialysis |
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作 者 | Juan, Kuo-chang; Fan, Pei-chun; Tsai, Ming-hung; Jenq, Chang-chyi; Hsu, Hsiang-hao; Chang, Ming-yang; Tian, Ya-chung; Chang, Chih-hsiang; Hung, Cheng-chieh; Fang, Ji-tseng; Yang, Chih-wei; Chen, Yung-chang; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷 期 | 25:2 2011.06[民100.06] |
頁 次 | 頁61-69 |
分類號 | 415.53 |
關鍵詞 | Liver transplantation; MARS; Molecular adsorbent recirculating system; SOFA; Sequential organ failure assessment; Child-pugh points; MELD; Model for end-stage liver disease; |
語 文 | 英文(English) |
英文摘要 | BACKGROUND: Molecular adsorbent recirculating system (MARS) dialysis can prolong survival and improve multiple organ dysfunctions in patients with fulminant hepatic failure (FHF). However, further clinical data and experiences are needed to confirm the effectiveness of this therapeutic strategy. The prognostic factors and scoring systems for predicting outcome in liver failure patients undergoing MARS dialysis must also be identified. METHODS: This study retrospectively reviewed the medical records of 57 liver failure patients who received MARS dialysis at a tertiary care university hospital from January, 2003 to June, 2009. Demographic, clinical, and laboratory variables were recorded. Each patient was assessed using four scoring systems pre- and post-MARS on Days 1, 2, and 3. RESULTS: The overall 90-day (after completion of all MARS dialysis sessions) survival rate was 21.1%. The Sequential Organ Failure Assessment (SOFA) score had better discriminatory power than Child-Pugh points, the model for end-stage liver disease (MELD), and the MELD plus sodium. Cumulative survival rates at 3-month follow-up after admission to intensive care unit (ICU) differed significantly (P < 0.05) between patients with SOFA scores ≤ 11 on post-MARS treatment Day 3 and those with SOFA scores >11 on post-MARS treatment Day 3. CONCLUSIONS: Though MARS improved laboratory parameters of hepatic detoxification in patients with FHF, the patients’ mortality remained unsatisfactorily high. Our experiences suggest that greater effort in finding a suitable liver donor is needed when using MARS in FHF. Of the four evaluated scoring systems, calculated SOFA scores on post-MARS treatment Day 3 have the best discriminative power for predicting 3-month mortality following MARS treatment. |
本系統中英文摘要資訊取自各篇刊載內容。