Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis.

Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Research Abstract Details 

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Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Abstract Text:

Cristina Ripoll,Roberto Groszmann,Guadalupe Garcia-Tsao,Norman Grace,Andrew Burroughs,Ramon Planas,Angels Escorsell,Juan Carlos Garcia-Pagan,Robert Makuch,David Patch,Daniel S Matloff,Jaime Bosch, ,Cristina Ripoll,Roberto Groszmann,Guadalupe Garcia-Tsao,Norman Grace,Andrew Burroughs,Ramon Planas,Angels Escorsell,Juan Carlos Garcia-Pagan,Robert Makuch,David Patch,Daniel S Matloff,Jaime Bosch, ,Cristina Ripoll,Roberto Groszmann,Guadalupe Garcia-Tsao,Norman Grace,Andrew Burroughs,Ramon Planas,Angels Escorsell,Juan Carlos Garcia-Pagan,Robert Makuch,David Patch,Daniel S Matloff,Jaime Bosch, ,

BACKGROUND AND AIMS: Our aim was to identify predictors of clinical decompensation (defined as the development of ascites, variceal hemorrhage [VH], or hepatic encephalopathy [HE]) in patients with compensated cirrhosis and with portal hypertension as determined by the hepatic venous pressure gradient (HVPG). METHODS: We analyzed 213 patients with compensated cirrhosis and portal hypertension but without varices included in a trial evaluating the use of beta-blockers in preventing varices. All had baseline laboratory tests and HVPG. Patients were followed prospectively every 3 months until development of varices or VH or end of study. To have complete information, until study termination, about clinical decompensation, medical record review was done. Patients who underwent liver transplantation without decompensation were censored at transplantation. Cox regression models were developed to identify predictors of clinical decompensation. Receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic capacity of HVPG. RESULTS: Median follow-up time of 51.1 months. Sixty-two (29%) of 213 patients developed decompensation: 46 (21.6%) ascites, 6 (3%) VH, 17 (8%) HE. Ten patients received a transplant and 12 died without clinical decompensation. Median HVPG at baseline was 11 mm Hg (range, 6-25 mm Hg). On multivariate analysis, 3 predictors of decompensation were identified: HVPG (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.05-1.17), model of end-stage liver disease (MELD) (HR, 1.15; 95% CI, 1.03-1.29), and albumin (HR, 0.37; 95% CI, 0.22-0.62). Diagnostic capacity of HVPG was greater than for MELD or Child-Pugh score. CONCLUSIONS: HVPG, MELD, and albumin independently predict clinical decompensation in patients with compensated cirrhosis. Patients with an HVPG <10 mm Hg have a 90% probability of not developing clinical decompensation in a median follow-up of 4 years.

Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Publishing Authors By Initials

C Ripoll,R Groszmann,G Garcia-Tsao,N Grace,A Burroughs,R Planas,A Escorsell,JC Garcia-Pagan,R Makuch,D Patch,DS Matloff,J Bosch, ,C Ripoll,R Groszmann,G Garcia-Tsao,N Grace,A Burroughs,R Planas,A Escorsell,JC Garcia-Pagan,R Makuch,D Patch,DS Matloff,J Bosch, ,C Ripoll,R Groszmann,G Garcia-Tsao,N Grace,A Burroughs,R Planas,A Escorsell,JC Garcia-Pagan,R Makuch,D Patch,DS Matloff,J Bosch, ,

For similar natural sciences: time: time factors research abstracts see: natural sciences: time: time factors research

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Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Gastroenterology

VOLUME: 133

Page Numbers: 481-8

Journal Abbreviation: Gastroenterology

ISSN: 0016-5085

DAY: 21

MONTH: 05

YEAR: 2007

Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Information

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LANGUAGE: eng

NlmUniqueID: 374630

Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Keywords Mesh Terms:

KEYWORDS: Time Factors

MESH TERMS: physiopathology

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Grant and Affiliation Information for Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis.

AFFILIATION: Veterans Affairs CT Healthcare System, Yale University School of Medicine, West Haven, Connecticut 06516, USA.

Country: United States

AGENCY: United States NIDDK

GRANT: R01 DK46580

ACRONYM: DK

MEDLINETA: Gastroenterology

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