Study of the prognosis factors in liver cirrhosis.
In a prospective study carried out on a group of 1210 patients with liver cirrhosis (LC), the diagnosis was based on clinical, biological and histological criteria, as well as on the prognostic significance of 20 clinical, biochemical and histological parameters. The group, including 830 males (68.59%) and 380 females (31.41%), with an average age of 49.27 +/- 13.18 years, was studied during periods of 6 to 16 months, the initial investigations being periodically repeated. The statistical significance of the prognosis factors was studied by uni- and multivariative methods, according to the model of Cox, with the help of an IMB computer. The survival rate for the group studied ranged from 6 to 204 months, with an average period of survival of 38.29 months. The multivariative analysis demonstrated that the prognosis factor with a best correlation with the death power is ascites, which has additional predictive significance in association with encephalopathy and/or jaundice. The multivariative analysis selects as clinical factors of unfavourable prognosis the cholestasis, the hepatocytolytic syndrome, the syndrome of liver deficiency and the age over 50. The limits of the biochemical parameters with unfavourable significance were: bilirubinemia level greater than 3 mg%, ASAT/ALAT = 50.24/70.33 u.i., prothrombinemic index less than 50% and albuminemia greater than 3 g%. The multivariative method proved also superior in appreciating the interrelations of the prognostic factors, emphasizing the significance of the clinical parameters (ascites, encephalopathy, jaundice), while the multivariative analysis differentiated the biochemical prognosis factors (bilirubinemia, ASAT/ALAT, prothrombinemic index, albuminemia) and their level of significance.
Buligescu
L
L
Dept. of Internal Medicine, Fundeni Hospital, Bucharest.
Voiculescu
M
M
Costin
A
A
Drăghici
I
I
D000328:Adult; D001201:Ascites / Q000453:epidemiology; D002779:Cholestasis / Q000453:epidemiology; D004487:Edema / Q000453:epidemiology; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006501:Hepatic Encephalopathy / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000401:mortality; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies