ArticleAnnals of intensive care2017
Prognosis of cirrhotic patients admitted to intensive care unit: a meta-analysis.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06121908 (Role of Blood Lactate Level in Prediction of Outcome of Cirrhotic Patients at The Intensive Care Unit), which is not on this map. Cited by 59 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Role of Blood Lactate Level in Prediction of Outcome of Cirrhotic Patients at The Intensive Care Unit
Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 128 citations in OpenAlex.
- Efficacy and safety of mesenchymal stem cell therapy in acute on chronic liver failure: a systematic review and meta-analysis of randomized controlled clinical trials.Stem cell research & therapy · 2025Pooled it
- Low-Dose Hydrocortisone in Cirrhotic Patients With Septic Shock: A Double-Blind Randomised Placebo-Controlled Trial.Liver international : official journal of the International Association for the Study of the Liver · 2025Trial
- Characteristics and prognosis of patients with cirrhosis presenting with acute respiratory distress syndrome: A bicentric retrospective study.Journal of intensive medicine · 2026Article
- Bridging Critically Ill Patients With Cirrhosis to Transplant With Renal Replacement Therapy: A Multicenter Cohort Study.Liver international : official journal of the International Association for the Study of the Liver · 2026Observational
- Interpretable model for early prediction of 28-day mortality in patients with cirrhosis and sepsis: a multi-cohort ICU study.BMC gastroenterology · 2026Article
- Using machine learning for early prediction of in-hospital mortality during ICU admission in liver cancer patients.Scientific reports · 2025Article
- Incidence and outcomes of extubation failure in mechanically ventilated patients with cirrhosis: a post-hoc analysis of a prospective multicenter study.Annals of intensive care · 2025Article
- Reconsidering the urea-to-creatinine ratio as a signal of muscle catabolism in patients with cirrhosis.Critical care (London, England) · 2025Article
- Acute-on-Chronic Liver Failure-Current Management and Future Perspectives.Biomedicines · 2025Review
- Breaking Barriers for Intensive Care Admission in Patients With Advanced HCC on Immunotherapy.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Outcomes for patients with alcohol-related liver disease admitted to Scottish intensive care units 2010-2018.Anaesthesia · 2025Article
- Long-term outcomes after ICU admission in critically ill patients with liver cirrhosis: An Australian state-wide cohort study.Hepatology communications · 2025Article
- Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit.United European gastroenterology journal · 2025Article
- Comparison of Open Albumin Dialysis (OPAL) With Prometheus Fractionated Plasma Separation and Adsorption (FPSA) and Standard Medical Treatment for Acute-On-Chronic Liver Failure.Artificial organs · 2025Article
- Albumin: A Review of Market Trends, Purification Methods, and Biomedical Innovations.Current issues in molecular biology · 2025Review
- Hypochloremia is an underutilised prognostic marker in patients with advanced liver cirrhosis and liver failure.World journal of hepatology · 2025Review
- Mechanisms and treatment approaches for ACLF.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Hepatorenal Syndrome: direct treatment costs and characteristics of patients admitted to intensive care.Einstein (Sao Paulo, Brazil) · 2025Observational
- Effects of 24-hour urine-output trajectories on the risk of acute kidney injury in critically ill patients with cirrhosis: a retrospective cohort analysis.Renal failure · 2024Article
- Early prediction of acute-on-chronic liver failure development in patients with diverse chronic liver diseases.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
17 authors at 10 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown.
methodsWe conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores).
resultsIn-ICU, in-hospital, and 6-month mortality was 42.7, 54.1, and 75.1%, respectively. Forty-eight patients (3.8%) underwent liver transplantation during follow-up. In-ICU mortality was lower in patients admitted for variceal bleeding (OR 0.46; 95% CI 0.36-0.59; p < 0.001) and higher in patients with SOFA > 19 at baseline (OR 8.54; 95% CI 2.09-34.91; p < 0.001; PPV = 0.93). High SOFA no longer predicted mortality at 6 months in ICU survivors. Twelve variables related to infection were predictors of in-ICU mortality, including SIRS (OR 2.44; 95% CI 1.64-3.65; p < 0.001; PPV = 0.57), pneumonia (OR 2.18; 95% CI 1.47-3.22; p < 0.001; PPV = 0.69), sepsis-associated refractory oliguria (OR 10.61; 95% CI 4.07-27.63; p < 0.001; PPV = 0.76), and fungal infection (OR 4.38; 95% CI 1.11-17.24; p < 0.001; PPV = 0.85). Among therapeutics, only dopamine (OR 5.57; 95% CI 3.02-10.27; p < 0.001; PPV = 0.68), dobutamine (OR 8.92; 95% CI 3.32-23.96; p < 0.001; PPV = 0.86), epinephrine (OR 5.03; 95% CI 2.68-9.42; p < 0.001; PPV = 0.77), and MARS (OR 2.07; 95% CI 1.22-3.53; p = 0.007; PPV = 0.58) were associated with in-ICU mortality without heterogeneity. In ICU survivors, eight markers of liver and renal failure predicted 6-month mortality, including Child-Pugh stage C (OR 2.43; 95% CI 1.44-4.10; p < 0.001; PPV = 0.57), baseline MELD > 26 (OR 3.97; 95% CI 1.92-8.22; p < 0.0001; PPV = 0.75), and hepatorenal syndrome (OR 4.67; 95% CI 1.24-17.64; p = 0.022; PPV = 0.88).
conclusionsPrognosis of cirrhotic patients admitted to ICU is poor since only a minority undergo liver transplant. The prognostic performance of general ICU scores decreases over time, unlike the Child-Pugh and MELD scores, even recorded in the context of organ failure. Infection-related parameters had a short-term impact, whereas liver and renal failure had a sustained impact on mortality.
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