Outcomes of cirrhotic patients admitted to the intensive care unit after a successful cardiac arrest resuscitation

Authors

• Moayed N. Alkhlewi, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Hasan M. Al-Dorzi, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Farhan Z. Alenezi, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Abdulrahman M. Farhat, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Hani Tamim, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Musharaf Sadat, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Felwa Bin Humaid, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.
• Yaseen M. Arabi, From the Department of Emergency Medicine and Critical Care (Alkhlewi); from the Intensive Care Department (Al-Dorzi, Alanazi, Sadat, Bin Humaid, Arabi), King Abdulaziz Medical City, and from the Ministry of National Guard-Health Affairs; from the College of Medicine (Alkhlewi, Al-Dorzi, Alanazi, Sadat, Tamim, Arabi), King Saud bin Abdulaziz University for Health Sciences; from King Abdullah International Medical Research Center (Alkhlewi, Al-Dorzi, Alanazi, Farhat, Tamim, Sadat, Humaid, Arabi), Riyadh; from the Faculty of Medicine (Farhat), Sulaiman Alrajhi University, Qassim, Kingdom of Saudi Arabia; and from the Department of Internal Medicine (Tamim), American University of Beirut, Beirut, Lebanon.

Abstract

Objectives: To evaluate the outcomes of cirrhotic patients admitted to the intensive care unit (ICU) following cardiac arrest. Methods: This was a single centre retrospective study of all the cirrhotic patients, admitted to the ICU at King Abdulaziz Medical City, Riyadh, Saudi Arabia, after a successful cardiac arrest resuscitation, from 1999 to 2017. The characteristics of the hospital survivors and non-survivors were compared. Results: A total of 76 patients were admitted to the ICU during the study period, with a median age of 64 years. In addition to cirrhosis, the patients had other chronic comorbidities, including chronic renal disease (32.9%) and diabetes (47%). Of this group, 67 (88.2%) died in the hospital, and 54 (71%) died while in ICU. Compared to the group who survived, all non-survivors required mechanical ventilation and had a higher median APACHE II score of 38 ( p =0.006), a lower median Glasgow coma score (GCS) of 3 ( p =0.0003), and a higher median lactic acid of 6.4 mmol/L ( p =0.032). On multivariable logistic regression analysis, the important predictors of hospital mortality were APACHE II score ( p =0.006), bilirubin level ( p =0.008) and GCS ( p =0.005). Conclusion: Cirrhotic patients admitted to the ICU following cardiac arrest have high mortality. Patients with higher APACHE II scores, higher bilirubin and lower GCS have higher risk of in-hospital mortality.

Article Type

Research Article

First Page

1320

Last Page

1324

Recommended Citation

Alkhlewi, Moayed N.; Al-Dorzi, Hasan M.; Alenezi, Farhan Z.; Farhat, Abdulrahman M.; Tamim, Hani; Sadat, Musharaf; Humaid, Felwa Bin; and Arabi, Yaseen M. (2021) "Outcomes of cirrhotic patients admitted to the intensive care unit after a successful cardiac arrest resuscitation," Saudi Medical Journal: Vol. 42: Iss. 12, Article 8.
DOI: https://doi.org/10.15537/smj.2021.42.12.20210478