Establishment and Validation of the new LIVERAID-ICU Score for Prognostic Assessment in Patients with Liver Cirrhosis and Infections in the Intensive Care Unit

Introduction: Admission of patients with liver cirrhosis to the intensive care unit (ICU) due to infections is common and often leads to complications such as hepatic encephalopathy, renal failure, and circulatory insufficiency, significantly increasing mortality risk. Rapid diagnosis and treatment are essential for improving outcomes. In this context, scoring models are crucial in ICUs for accurately assessing disease severity and guiding therapeutic strategies. However, there are no specific scoring models to predict mortality in ICU patients with cirrhosis-related infections. This study aims to develop an improved prognostic scoring model that accurately predicts in-hospital mortality in liver cirrhosis patients with infections in the ICU.

Methods: A retrospective analysis was conducted on 620 patients with liver cirrhosis treated for infections between 2017 and 2019 in the gastroenterological ICU of the Department of Internal Medicine I at the University Hospital Regensburg. Based on this cohort, the LIVERAID (LIVER And Infectious Diseases)-ICU Score was developed and validated.

Results: The LIVERAID-ICU Score includes the Child-Pugh stage, serum urea level, and Horovitz quotient. It is designed for bedside calculation using simple clinical and laboratory data, without requiring additional tools. In the validation cohort, the LIVERAID-ICU Score demonstrated higher sensitivity and specificity (AUC=0.83) in predicting in-hospital mortality compared to established scores like SOFA (p=0.045), MELD (p=0.097), Child (p<0.001), and CLIF-C-ACLF (p<0.001).

Conclusions: The newly developed LIVERAID-ICU Score is a robust, easy-to-use tool for predicting in-hospital mortality in liver cirrhosis patients with infections.

Publication History

Article published online:
20 January 2025