Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2025; 17(3): 99570
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.99570
Correlations of three scoring systems with the prognosis of patients with liver cirrhosis complicated with sepsis syndrome
Li-Nan Liu, Yu-Fei Chang, Hui Wang
Li-Nan Liu, Yu-Fei Chang, Hui Wang, Department of Emergency, Beijing Ditan Hospital Capital Medical University, Beijing 100102, China
Author contributions: Liu LN designed the study, collected and analyzed data, and wrote the manuscript; Liu LN, Chang YF and Wang H participated in the study’s conception and data collection; Liu LN and Wang H participated in study design and provided guidance; All authors read and approved the final version.
Institutional review board statement: This study was approved by the Ethic Committee of Beijing Ditan Hospital Captital Medical University, No. 2024-05.
Informed consent statement: Due to the retrospective and de-identified nature of this study, written informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Nan Liu, Department of Emergency, Beijing Ditan Hospital Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing 100102, China. 13911067330@163.com
Received: October 23, 2024
Revised: December 2, 2024
Accepted: January 16, 2025
Published online: March 27, 2025
Processing time: 123 Days and 17.2 Hours
Abstract
BACKGROUND

Severe symptoms associated with sepsis syndrome (SS) are considered a severe threat, which not only increases therapeutic difficulty but also causes a prognostic mortality rate. However, at present, few related studies focused on the application of different score scales for disease and prognosis assessment in liver cirrhosis (LC) complicated with SS.

AIM

To determine the correlations of the model for end-stage liver disease (MELD), sequential organ failure assessment (SOFA), and modified early warning score (MEWS) points with the prognosis of patients with LC complicated with SS.

METHODS

This retrospective analysis included 426 LC cases from February 2019 to April 2022. Of them, 225 cases that were complicated with SS were assigned to the LC + SS group, and 201 simple LC cases were included in the LC group. Intergroup differences in MELD, SOFA, and MEWS scores were compared, as well as their diagnostic value for LC + SS. The correlations of the three scores with the prognosis of patients with LC + SS were further analyzed, as well as the related risk factors affecting patients’ outcomes, after the follow-up investigation.

RESULTS

MELD, SOFA, and MEWS scores were all higher in the LC + SS group vs the LC group, and their combined assessment for LC + SS revealed a diagnostic sensitivity and a specificity of 89.66% and 90.84%, respectively (P < 0.05). The LC + SS group reported 58 deaths, with an overall mortality rate of 25.78%. Deceased patients presented higher MELD, SOFA, and MEWS points than those who survived (P < 0.05). MELD, SOFA, and MEWS scores were determined by COX analysis as factors independently affecting the prognosis of patients with LC + SS (P < 0.05).

CONCLUSION

MELD, SOFA, and MEWS effectively diagnosed LC in patients complicated with SS, and they demonstrated great significance in assessing prognosis, which provides a reliable prognosis guarantee for patients with LC + SS. However, their assessment effects remain limited, which is worthy of further investigation by more in-depth and rigorous experimental analysis.

Keywords: Model for end-stage liver disease; Sequential organ failure assessment; Modified early warning score; Cirrhosis; Sepsis syndrome

Core Tip: Severe symptoms and associated complications are crucial factors causing the death of patients with liver cirrhosis (LC). Among them, sepsis syndrome (SS) is a kind of severe threat, which not only increases therapeutic difficulty but also causes a prognostic mortality rate. This study confirmed the correlations of the model for end-stage liver disease, sequential organ failure assessment, and modified early warning score points with the prognosis of patients with LC complicated with SS.