Clinical—Liver, Pancreas, and Biliary TractInfections in Patients With Cirrhosis Increase Mortality Four-Fold and Should Be Used in Determining Prognosis
Section snippets
Materials and Methods
All studies reporting on the clinical course of cirrhosis after infection were considered eligible for this review, irrespective of the publication language, if they fulfilled the following criteria: (1) inclusion of adult patients with cirrhosis independent of etiology; and (2) reported the number of deaths in infected patients, or a survival analysis. Exclusion criteria were studies with the following: (1) no separate analysis of patients with or without cirrhosis; (2) no separate analysis of
Study Characteristics
The search yielded 10,508 references, with 12 derived from abstracts and references of the reports. There were 10,153 exclusions after reading the title and/or abstract because they were not relevant; from the remainder, 177 were excluded after reading the reports because they did not meet inclusion/exclusion criteria. Therefore, 178 studies were included (88 published from 2000 onward). There were 225 cohorts in total because some studies had separate cohorts with infection. Detailed
Discussion
The natural history of cirrhosis is characterized by an asymptomatic phase termed compensated cirrhosis, followed by a rapidly progressive phase marked by the development of complications of portal hypertension and/or liver dysfunction (ascites, variceal bleeding, portosystemic encephalopathy, jaundice), termed decompensated cirrhosis. These complications further worsen mortality. This 2-stage model has been modified by D'Amico et al,5 who presented evidence for 4 stages of cirrhosis: 2 stages
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Conflicts of interest The authors disclose no conflicts.