Combination of serum sodium and lactate as a better predictor of mortality in critically ill patients with decompensated Liver Disease admitted in ICU ; A prospective observational study

Liver Cirrhosis is a common chronic disease that is also a leading cause of death among non malignant diseases.Decompensated cirrhosis also called Decompendsated Liver disease is defined as acute deterioration of liver function in a patinet with cirrhosis and is characterised by jaundice , ascites , hepatic encephalopathy , hepatorenal syndrome , or variceal haemorrhage .Patients with Decompensated liver disease (DCLD) with biochemical abnormalities often need to be admitted in intensive care units. Low serum sodium levels and high serum lactate levels are often common biochemical abnormality found in them . Traditionally, prognosis of DCLD has been determined by the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scoring systems (6). MELD and CTP scores have been known to have their own limitations. Studies which have considered sodium and lactate together as prognostic marker for inpatient mortality in DCLD are limited. Serum sodium and lactate are a readily available, reproducible, and objective laboratory tests.  Thus prognostic value of both sodium and Lactate value taken together into consideration needed further investigation . We plan to perform a prospective observational study to explore the impact of serum sodium, lactate or a combination of serum sodium and lactate on 28-day mortality in patients with decompensated liver disease admitted to ICU of Dr B L Kapur Hospital New Delhi.