Pulmonary impairment independently determines mortality in critically ill patients with acute‐on‐chronic liver failure

• DOI: 10.1111/liv.15343
• Publication Date: 2022-06-21T17:34:50Z
• Authors: Martin S. Schulz; Jan Mengers; Wenyi Gu; Andreas Drolz; Philip G. Ferstl; Alex Amoros; Frank E. Uschner; Nora Ackermann; Georg Guttenberg; Alexander Queck; Maximilian J. Brol; Christiana Graf; Philipp Stoffers; Anna‐Lena Laguna ...; Carla Cremonese; Hans‐Peter Erasmus; Martin W. Welker; Achim Grünewaldt; Vincente Arroyo; Jörg Bojunga; Javier Fernandez; Stefan Zeuzem; Johannes Kluwe; Kai‐Hendrik Peiffer; Christoph Welsch; Valentin Fuhrmann; Gernot Rohde; Jonel Trebicka
• Keywords: Liver Cirrhosis; ddc:610; 03 medical and health sciences; 0302 clinical medicine; Critical Illness; 610; Humans; Acute-On-Chronic Liver Failure; Prognosis; Lung; Retrospective Studies; 3. Good health

In ACLF patients, an adequate risk stratification is essential, especially for liver transplant allocation, since associated with high short-term mortality. The CLIF-C score the best prognostic model to predict outcome in patients. While lung failure generally regarded as signum malum ICU care, this study aims evaluate and quantify role of pulmonary impairment on patients.In retrospective study, 498 patients cirrhosis admission IMC/ICU were included. was defined according EASL-CLIF criteria. Pulmonary classified into three groups: unimpaired ventilation, need mechanical ventilation failure. These factors analysed different cohorts, including a propensity score-matched cohort.Mechanical identified independent increased matched presence showed highest 28-day mortality (83.7%), whereas rates (67.3%) without (38.8%) considerably lower (p < .001). Especially impairment, poor predictive accuracy. Adjusting grade improved prediction significantly.This highlights that not only but also worse prognosis should be considered assessment new may useful selection transplantation.