Survival In Cirrhosis

##plugins.themes.academic_pro.article.main##

Asma Ouakaa-Kchaou
Najet Belhadj
Nabil Abdelli
Msadek Azzouz
Nabyl Ben Mami
Mohamed Hedi Dougui
Taoufik Najjar
Jamel Kharrat
Adeljabbar Ghorbel

Abstract

Background: Assessment of prognosis in patients with cirrhosis is important so as to plan their management.
Aim : To determine the survival rates and to identify indicators associated with shorter life expectancy in Tunisians patients with cirrhosis.
Methods: This is a retrospective study of in-patients with cirrhosis during a 5-years period. We studied clinical and biochemical characteristics of all patients and the occurrence of decompensation or complication. The overall survival, mortality rate and causes of death were reviewed. Univariate and multivariate analysis was performed on all variables to identify parameters associated with a lower life expectancy.
Results: We studied 222 patients (60% females) with a mean age of 60 years. Mean follow up was 22 months. The overall survival was 52,5% at 5 years. With univariate analysis, 10 variables were associated with a poor prognosis: male gender, decompensation at admission, Child-Pugh C, esophageal varices, hypertensive gastropathy, occurrence of spontaneous bacterial peritonitis, hepatic encephalopathy, hepato-renal syndrome, hepatocellular carcinoma and portal thrombosis. With multivariate analysis, only male gender was independently correlated with survival.
Conclusion: In our study, male gender was an uncommon parameter that predicts survival in cirrhotic patient. The Child-Pugh score was a good index for assessing the prognosis.

Keywords:

cirrhosis, survival, prognosi

##plugins.themes.academic_pro.article.details##

References

  1. Saunders JB, Walters JRF, Davies P, Paton A. A 20 years prospective study of cirrhosis. BMJ 1981; 282:263-6.
  2. Karoui S, Hamzaoui S, Sahli F, Matri S, Boubaker J, Filali F. Mortalité au cours des cirrhoses: prévalence, causes et facteurs prédictifs. Tunis Med 2002;80:21-5.
  3. D'Amico G, Morabito A, Pagliaro L, Marubini E, and the liver study group of “V. Cervello” hospital. Survival and prognostic indicators in compensated and decompensated cirrhosis. Dig Dis Sci 1986;31:468-75.
  4. Propst A, Propst T, Zangerl G, Ofner D, Judmaier G, Vogel W. Prognosis and life expectancy in chronic liver disease. Dig Dis Sci 1995;40:1805-15.
  5. Bustamante J, Rimola A, Ventura PJ, Navasa M, Cirera I. Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol 1999;30:890-5.
  6. Pagliaro L, Simonetti RG, Craxi A, Spano C, Filippazzo G. Alcohol and HBV infection at risk factors for hepatocellular carcinoma in Italy: a multicentric controlled study. Hepatogastroenterology 1983;30:48-50.
  7. Fernandez-Esparrach G, Sanchez-Fueyo A, Ginès P, Uriz J, Quinto L. A prognostic model for predicting survival in cirrhosis with ascites. J. Hepatol 2001;34:46-52.
  8. Yoneyama K, Taniguchi H, Kiuchi Y, Shibata M, Mitamura K. Prognostic index of liver cirrhosis with ascites with and without hepatocellular carcinoma. Scand J Gastroenterol 2004;12:1272-9.
  9. Gentilini P, Laffi G, La Villa G, Romanelli R, Buzzelli G, Casini- Raggi V. Long course and prognosis factors of virus induced cirrhosis of the liver. Am J Gastroenterol 1997;92:66-72.
  10. Castera L, Pauwels A, Lévy V. Indicateurs pronostiques chez les malades atteints de cirrhose admis en service de réanimation. Gastroenterol Clin Biol 1996 ; 20:263-8.
  11. Magliocchetti N, Torchio P, Corrao G, Arico S, Favilli S. Prognostic factors for long term survival in cirrhotic patients after the first episode of liver decompensation. Ital J Gastroenterol Hepatol 1997; 29:38-46.
  12. Ho YP, Chen YC, Yang C, Lien JM, Chu Y, Fang JT. Outcome prediction for critically ill cirrhotic patients: a comparison of apache II and Child-Pugh scoring systems. J Int Care Med 2004;19:105-10.
  13. Attia KA, Ackoundou KC, N'dri AT, et al. Child-Pugh-Turcott versus MELD score for predicting survival in a retrospective cohort of black African cirrhotic patients. World J Gastroenterol 2008;14:286-91.
  14. Botta F, Giannini E, Romagnoli P, Fasoli A, Malfatti B, Testa R. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. GUT 2003;52:134-9.
  15. Cholongitas E, Papatheodoridis G, Vangeli M, Terreni N, Patch D. Systematic review: the model for end-stage liver disease - should it replace Child-Pugh's classification for assessing prognosis in cirrhosis? Aliment Pharmacol Ther 2005;22:1079- 89.