Afro-Egypt J Infect  Endem  Dis  2018 December ; 8(4):182

Current Evaluation of Sepsis among Patients with Liver Cirrhosis

Elsayed Saad Abd Elbaser and Olfat Abdel-Monem Ibrahim*

Tropical Medicine and Anaesthesia* Departments, Faculty of Medicine, Zagazig University,                                           Zagazig, Egypt dr.sayedsaad79@gmail.com

 

ABSTRACT

Background and study aim: patients with liver cirrhosis have high incidence of sepsis. Spontaneous bacterial peritonitis and urinary tract infections are the most common infections among patients with liver cirrhosis. New criteria including quick qSOFA and sepsis-3 criteria are used for diagnosing sepsis in patients with liver cirrhosis. These criteria appear to be more accurate than SIRS. The aim of this study is to evaluate the existing scoring systems in our patients with liver cirrhosis to identify patients with sepsis.

Patients and Methods: This prospective study included 288 consecutive patients previously diagnosed to have liver cirrhosis and suspected to have bacterial/fungal infections. Quick Sequential (sepsis-related) organ failure assessment (qSOFA) criteria and sepsis-3 criteria were used to identify patients with organ dysfunction due to sepsis.

Results: qSOFA and sepsis-3 criteria are more accurate than SIRS in detecting sepsis among patients with cirrhosis (The area under the receiver operating characteristic curve (AUROC) value for a model with qSOFA and sepsis-3 was AUROC: 0.77 and 0.76), while AUROC for SIRS was 0.66.

Conclusion: Sepsis-3 and qSOFA are more accurate than SIRS criteria in early detection of sepsis among patients with cirrhosis. Patients with positive criteria need intensive management due to high risk of in-hospital mortality.