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Intensive Care Medicine
Published in: Intensive Care Medicine 11/2007

01-11-2007 | Original

RIFLE classification can predict short-term prognosis in critically ill cirrhotic patients

Authors: Chang-Chyi Jenq, Ming-Hung Tsai, Ya-Chung Tian, Chan-Yu Lin, Chun Yang, Nai-Jen Liu, Jau-Min Lien, Yung-Chang Chen, Ji-Tseng Fang, Pan-Chi Chen, Chih-Wei Yang

Published in: Intensive Care Medicine | Issue 11/2007

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Abstract

Objective

End-stage liver disease is frequently complicated by renal function disturbances. Cirrhotic patients with renal failure admitted to intensive care units (ICUs) have high mortality rates. This study analyzed the outcomes of critically ill cirrhotic patients and identified the association between prognosis and RIFLE (risk of renal failure, injury to kidney, failure of kidney function, loss of kidney function, and end-stage renal failure) classification, in comparison with other five scoring systems.

Design

Prospective, clinical study.

Setting

Ten-bed specialized hepatogastroenterology ICU in a university hospital in Taiwan.

Patients and participants

One hundred and thirty-four cirrhotic patients consecutively admitted to ICU during a 1.5-year period.

Interventions

Thirty-two demographic, clinical and laboratory variables were analyzed as predictors of survival.

Measurements and main results

Overall hospital mortality was 65.7%. There was a progressive and significant increase (χ2 for trend: p < 0.001) in mortality based on RIFLE classification severity. Multiple logistic regression analysis indicated that RIFLE classification and Sequential Organ Failure Assessment (SOFA) score on the first day of ICU admission were independent risk factors for hospital mortality. By using the areas under the receiver operating characteristic curve (AUROC), the RIFLE category and SOFA both indicated a good discriminative power (AUROC 0.837 ± 0.036 and 0.917 ± 0.025; p < 0.001). Cumulative survival rates at 6-month follow-up differed significantly (p < 0.05) for non-ARF vs. RIFLE-R, RIFLE-I, and RIFLE-F.

Conclusion

Both SOFA and RIFLE category showed high discriminative power in predicting hospital mortality in critically ill patients with cirrhosis. The RIFLE classification is a simple and easily applied evaluative tool with good prognostic abilities.
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Metadata
Title
RIFLE classification can predict short-term prognosis in critically ill cirrhotic patients
Authors
Chang-Chyi Jenq
Ming-Hung Tsai
Ya-Chung Tian
Chan-Yu Lin
Chun Yang
Nai-Jen Liu
Jau-Min Lien
Yung-Chang Chen
Ji-Tseng Fang
Pan-Chi Chen
Chih-Wei Yang
Publication date
01-11-2007
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 11/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0760-6

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