The aim of this study is to examine the outcome of septic patients with
cirrhosis admitted to the intensive care unit (ICU) and predictors of mortality.Single center, retrospective cohort study.The study was conducted in
Intensive care Department of King Abdulaziz Medical City, Riyadh, Saudi Arabia.Data was extracted from a prospectively collected ICU database managed by a full time data collector. All patients with an admission diagnosis of
sepsis according to the sepsis-3 definition were included from 2002 to 2017. Patients were categorized into 2 groups based on the presence or absence of
cirrhosis.The primary outcome of the study was in-hospital mortality. Secondary outcomes included ICU mortality, ICU and hospital lengths of stay and
mechanical ventilation duration.A total of 7906 patients were admitted to the ICU with
sepsis during the study period, of whom 497 (6.29%) patients had
cirrhosis. 64.78% of cirrhotic patients died during their
hospital stay compared to 31.54% of non-cirrhotic. On multivariate analysis,
cirrhosis patients were at greater odds of dying within their
hospital stay as compared to non-
cirrhosis patients (Odds ratio {OR} 2.53; 95% confidence interval {CI} 2.04 - 3.15) independent of co-morbidities, organ dysfunction or hemodynamic status. Among
cirrhosis patients, elevated international normalization ratio (INR) (OR 1.69; 95% CI 1.29-2.23),
hemodialysis (OR 3.09; 95% CI 1.76-5.42) and
mechanical ventilation (OR 2.61; 95% CI 1.60-4.28) were the independent predictors of mortality.Septic
cirrhosis patients admitted to the intensive care unit have greater odds of dying during their
hospital stay. Among septic
cirrhosis patients, elevated INR and the need for
hemodialysis and
mechanical ventilation were associated with increased mortality.