title: 1-year survey of patients with advanced liver cirrhosis. Prognostic value of clinical and laboratory indexes identified by the Cox regression model.
abstract: The relation between coagulation indexes and survival rate was studied and analyzed in 46 patients with advanced liver cirrhosis (grade B and C Child-Pugh Classification), during a follow-up of 1 year. Twenty-four patients (52%) died of liver failure or fatal haemorrhage within 12 months of follow-up. Prothrombin activity, fibrinogen, fibrin(ogen) degradation products, prekallikrein and factor VII, serum bilirubin, and the degree of liver insufficiency, scored by Child-Pugh classification, proved to be significantly correlated with survival by univariate analysis. A multivariate survival analysis (Cox regression model) disclosed two variables, prekallikrein and factor VII, that predicted survival. The rate ratios of death increased to 2.8 and 7.6 with values of prekallikrein < 26% and factor VII < 39%, respectively. This study shows that some simple laboratory tests exploring the clotting system may identify patients with poor prognosis in severe liver failure.
authors.affiliation: University of Rome, Umberto I Policlinic, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Ferro
authors.forename: M
authors.initials: M
authors.lastname: Saliola
authors.forename: C
authors.initials: C
authors.lastname: Quintarelli
authors.forename: C
authors.initials: C
authors.lastname: Alessandri
authors.forename: S
authors.initials: S
authors.lastname: Basili
authors.forename: C
authors.initials: C
authors.lastname: Cordova
authors.forename: M S
authors.initials: MS
authors.lastname: Bonavita
authors.forename: F
authors.initials: F
authors.lastname: Violi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001780:Blood Coagulation Tests / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000097:blood* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate