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

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.