Mechanically ventilated liver failure patients’ aggressive treatment has been questioned in a study, as they commonly succumb to multiorgan failure. Survivors, on the other hand, have a chance at a liver transplant, and understanding mortality predictors may help reduce wait-list mortality. Researchers wanted to find out how this population fared and which characteristics predicted death. A retrospective analysis of 131 mechanically ventilated liver failure patients hospitalized to a large liver transplant center’s intensive care unit (ICU) from January 2011 to June 2014, with a one-year follow-up period. Hepatic encephalopathy was the most prevalent reason for ICU admission and intubation. The average duration of intubation was four days. Patients who were intubated for a variety of reasons spent the most duration on mechanical ventilation, averaging 12 days, followed by those who had sepsis or respiratory failure. In-hospital and one-year mortality rates were 54% and 71%, respectively. Only 5 of the 27 individuals on the transplant waiting list obtained an organ. In one year, patients who were readmitted to the ICU were four times as likely to die. The biggest predictors of overall mortality were a Model for End-Stage Liver Disease (MELD) score of >40 and chronic renal disease. In-hospital mortality was only predicted by a MELD score of more than-40. Additional predictors of postdischarge death were acute renal failure, ICU readmission, and hepatic encephalopathy.
In-hospital mortality continues to be high, at 54%. Overall, in-hospital, and post-discharge mortality were all predicted by the MELD score. In one year, patients who were readmitted to the ICU were four times as likely to die. The majority of liver transplant applicants died while waiting for an organ.
