The systemic inflammatory response index (SIRI) can effectively predict the mortality risk of patients with chronic-on-acute liver failure complicated by infection

This article studies the clinical prognosis of patients with acute-on-chronic liver failure (ACLF) complicated by infection, and explores the value of the systemic inflammatory response index (SIRI) in predicting 90-day mortality risk. The study retrospectively analyzed the clinical data of 579 patients, finding that HBV infection and alcoholic liver disease are the main causes, and abdominal and pulmonary infections are common. The 90-day mortality rate reached 63.73%. Through multivariate logistic regression analysis, it was confirmed that SIRI, blood ammonia, MELD-Na score, Child-Pugh score, age, and the presence of hepatic encephalopathy or acute renal injury are independent risk factors for 90-day mortality. Pearson correlation analysis showed that SIRI is positively correlated with MELD-Na and Child-Pugh scores. ROC curve analysis indicated that the AUC of SIRI in predicting 90-day mortality is 0.855, significantly higher than that of MELD-Na (0.734) and Child-Pugh (0.690), and the combined use can further improve the predictive power of the latter two. Kaplan-Meier analysis showed that the 90-day survival rate of patients with SIRI≥4.08 was significantly reduced (11.29% vs 66.92%). The innovation lies in the first systematic verification of the independent prognostic value of SIRI in the ACLF complicated by infection population, proposing it as a simple, economical, and efficient new inflammatory marker, superior to traditional scoring models, and with important clinical application prospects.