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01-12-2020 | Liver Transplantation | Research

pCLIF-SOFA is a reliable outcome prognostication score of critically ill children with cirrhosis: an ESPNIC multicentre study

Authors: Caroline Claude, Akash Deep, Martin Kneyber, Salman Siddiqui, Sylvain Renolleau, Luc Morin, Emmanuel Jacquemin, Jean-Paul Teglas, Vincent Gajdos, Pierre Tissières, Philippe Durand, the ESPNIC liver failure, support working group

Published in: Annals of Intensive Care | Issue 1/2020

Abstract

Background and aims

Data on outcome of critically ill children with cirrhosis are scarce. We aimed to evaluate the prognostic accuracy of sequential organs scoring systems in children with cirrhosis admitted to Paediatric Intensive Care Units (PICU).

Methods

We performed a multicentre retrospective analysis of children with cirrhosis admitted into four European PICUs between 2011 and 2016. Investigators were members of the ESPNIC liver failure and support working group. Paediatric End-Stage Liver Disease (PELD) and paediatric chronic liver failure sequential organ failure assessment score (pCLIF-SOFA) diagnostic accuracy for 28- and 60-day liver transplantation, 28-day mortality and 60-day composite outcome (ie. death or liver transplantation) were tested.

Results

One-hundred-and-thirty children were included. The main causes for PICU admission were acute-on-chronic liver failure (ACLF), gastrointestinal bleeding and sepsis. Twenty-nine percent died and 22.3% were transplanted by day-60 after PICU admission. On multivariable analysis, pCLIF-SOFA was the only predictor of mortality at day-28 and of composite outcome. Both pCLIF-SOFA and ACLF were independently associated with emergent liver transplantation. The pCLIF-SOFA score higher than 9 well predicted a 28-day mortality with a sensitivity of 87.8% and a specificity of 77.3%. A pCLIF-SOFA score higher than 7 was independently associated with liver transplantation on day-60. Stage 3 AKI assessed with KDIGO classification was significantly associated with 28-day mortality.

Conclusions

Half of critically ill cirrhotic children admitted to PICU either died or were transplanted within the initial 28-day period. On admission pCLIF-SOFA score accurately identify patients transplanted at day-28 and day-60 to those alive without LT and is associated with 28-day mortality and composite outcome at day-60.

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Title: pCLIF-SOFA is a reliable outcome prognostication score of critically ill children with cirrhosis: an ESPNIC multicentre study
Authors: Caroline Claude
Akash Deep
Martin Kneyber
Salman Siddiqui
Sylvain Renolleau
Luc Morin
Emmanuel Jacquemin
Jean-Paul Teglas
Vincent Gajdos
Pierre Tissières
Philippe Durand
the ESPNIC liver failure, support working group
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keywords: Liver Transplantation
Acute Kidney Injury
Septicemia
Septicemia
Liver Transplantation
Liver Transplantation
Pediatric Intensive Care
Liver Transplantation
Liver Transplantation
Acute Kidney Injury
Published in: Annals of Intensive Care / Issue 1/2020
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-020-00753-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

pCLIF-SOFA is a reliable outcome prognostication score of critically ill children with cirrhosis: an ESPNIC multicentre study

Abstract

Background and aims

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and aims

Methods

Results

Conclusions

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