Cirrhosis, Liver, Hepatic Insufficiency
Conditions
Keywords
Hepatic Insufficiency, Cirrhosis, Liver, Lymphohistiocytic hemophagocytosis, Hepatocellular insufficiency, Invasive aspergillosis, Azole antifungals, Liver dysfunction.
Brief summary
Patients with hepatocellular insufficiency and/or cirrhosis are at risk of developing invasive fungal infections, particularly in critical care settings. In international recommendations, voriconazole is positioned as the first-line treatment for invasive aspergillosis. However, this molecule-and the azole class of antifungals-is associated with frequent hepatic toxicity. Available since 2018, isavuconazole appears to be better tolerated in patients without pre-existing liver dysfunction. The aim of this study is to retrospectively evaluate the validity of the hscore in intensive care and resuscitation patients.
Interventions
None listed
Sponsors
University Hospital, Strasbourg, France
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patient (≥18 years old) * Patient admitted to the intensive care unit at Hautepierre Hospital, Strasbourg University Hospital, between January 1, 2014, and December 31, 2024 * At least 3 biological signs of HLH: * ferritin \> 2000 ng/mL * triglycerides \> 1.5 g/L * at least one cytopenia (leukocytes ≤ 5000 G/L, platelets ≤ 110 G/L, hemoglobin ≤ 9.2 g/dL).
Exclusion criteria
Refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| hscore | Up to 12 months | The HScore adds up points assigned to 9 clinical, biological, and histological criteria: The higher the total score, the greater the likelihood of HLH: Possible total score: 0 to 337: HScore: Probability of HLH: \< 90 points → Very low * 130 points → ≈ 10-20% 168 points → high probability of HL |
Countries
France
Contacts
Primary ContactAntonin HUGEROT, MD
Outcome results
None listed