Validation of Circom comorbidity score in critically-ill cirrhotic patients

Theodor Bilharz Research Institute

Bibliographic Information

Authors: EL-Ghannam M.; Abdelrahman Y.; Abu-Taleb H.; Hassan M.; Hassanien M.; EL-Talkawy M.D.

Journal: Clinical Epidemiology and Global Health

Publisher: Elsevier B.V.

Publication Date: July 2021

Volume / Issue: Volume 11

Article No.: 100728

ISSN: 22133984

DOI: 10.1016/j.cegh.2021.100728

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

EL-Ghannam M., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; Abdelrahman Y., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; Abu-Taleb H., Biostatistics and Demography, Department of Environmental Research, Theodor Bilharz Research Institute, Giza, Egypt; Hassan M., Immunology Department, Theodor Bilharz Research Institute, Giza, Egypt; Hassanien M., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; EL-Talkawy M.D., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt

Abstract

Background and aim of work: CirCom score has been designed specifically for cirrhotic patients as it is used to reassess which comorbidities associate with mortality of those patients. The current study was designed to assess the performance of CirCom comorbidity score in predicting the mortality of critically ill cirrhotic patients of hepatitis C virus (HCV) etiology. Methodology: 1085 consecutive patients admitted to the ICU in a two-year period were included. All were anti-HCV Ab positive with liver cirrhosis and portal hypertension as evidenced by clinical examination, laboratory, ultrasonographic and endoscopic features. None of them received oral antiviral treatment. Results: Out of the 1085 Patients, 321 (29.5%) patients died and 764 (70.4%) survived. Co-morbidities were found in 572 (52.7%), CirCom score 0 in 47.28%, 1 + 0 in 4.33%, 1 + 1 in 7.19%, 3 + 0 in 6.45%, 3 + 1 in 9.4%, 5 + 0 in 12.16%, 5 + 1 in 13.18%. Adjusted ORs for increased risk of death were 2.07, 2.65, 4.62, 6.72, 8.43 and 12.87, respectively. Overall, the model correctly predicted 82.24% of patients. Conclusion: The CirCom score performance as a measure of the burden of comorbidity in critically ill cirrhotic patients is fairly good and 82.24% of patients were correctly predicted by the model. Actual and expected survivals were comparable. This emphasizes the importance of including a measure of comorbidity in comparative studies of cirrhosis survival. © 2021 The Authors

Keywords

CirCom comorbidity score; Critically ill cirrhotic; ICU mortality; Risk score; amino acid; antibiotic agent; aspartic acid; enbucrilate; enema; epinephrine; hepatitis C antibody; octreotide; ornithine; rifaximin; adult; alcoholism; antibiotic therapy; argon plasma coagulation; Article; cerebrovascular disease; chronic kidney failure; chronic obstructive lung disease; clinical examination; cohort analysis; coma; comorbidity; comorbidity assessment; controlled study; critical illness; critically ill patient; diabetes mellitus; echography; Egyptian; esophagus surgery; esophagus varices; female; gastrointestinal endoscopy; hepatitis C; human; hypertension; intensive care unit; ischemic heart disease; laboratory test; liver cell carcinoma; liver cirrhosis; major clinical study; male; metastasis; middle aged; mortality; mortality risk; nonhuman; peptic ulcer; peptic ulcer bleeding; portal hypertension; priority journal; prospective study; protein restriction; sodium restriction; stomach varices; substance abuse; survival prediction; validation study

Citation Information

Scopus Citations: 1

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