O Doente Cirrótico na Unidade de Cuidados Intensivos: Avaliação do Prognóstico The Cirrhotic Patient in the Intensive Care Unit: Evaluation of the Prognosis

I INTRODUCTIONCirrhotic patients admitted in Intensive Care Units (ICU) have a poor prognosis. The prognosis of these patients can be evaluated with general scores (SOFA, APACHE, SAPS) or with specific scoring systems for liver disease (MELD, Child-Pugh). AIMS:To evaluate the prognostic value of general scores (SOFA, APACHE and SAPS) and of liver-speci- fic scores (MELD and Child-Pugh) in patients with liver cirrhosis admitted to general ICUs or to Gastroenterology Intensive Care Units (GICU). MATERIAL AND METHODS:The authors present a literature review on the assessment of the prognosis of cirr- hotic patients admitted to ICUs and also report your experience on this issue in the context of a specialized GICU including the analysis of 124 admissions. RESULTS: In several studies on patients with liver cirrhosis admitted to general ICUs, both general and liver-specific scores showed good discrimination, with an area under receiver operating characteristic curve (AUC) > 0.7. Considering the six most representative studies, the mean value of AUC on SOFA, APACHE II, APACHE III, MELD and Child-