Prognostic significance of portal hemodynamics in patients with compensated cirrhosis.
The prognostic value of portal hemodynamics, measured by pulsed echo-Doppler, was prospectively evaluated, together with clinical, biochemical and endoscopic parameters, in a series of 50 consecutive patients with compensated cirrhosis. After a mean follow-up of 6 years, 25 patients had died, all from complications of liver disease. Among conventional variables, the step-wise Cox model showed that only the Child-Pugh score independently predicted death (chi 2 = 18.66; p < 0.001). When hemodynamic parameters were added to the Child-Pugh score in the same model, portal blood velocity was shown to add prognostic significance (improvement in chi 2 = 14.06; p = 0.0002; Wald test). The present study shows that a portal blood velocity below the lower limit of controls (10 cm/s) characterizes patients with shorter survival, and suggests that this non-invasive parameter should be associated to the Child-Pugh score in the evaluation of patients with cirrhosis.
Zoli
M
M
Istituto di Clinica Medica Generale e Terapia Medica, Università di Bologna, Italy.
Iervese
T
T
Merkel
C
C
Bianchi
G
G
Magalotti
D
D
Marchesini
G
G
Gatta
A
A
Pisi
E
E
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002635:Chenodeoxycholic Acid / Q000627:therapeutic use; D002769:Cholelithiasis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D005260:Female; D006439:Hemodynamics; D006501:Hepatic Encephalopathy / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012039:Regional Blood Flow; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D014463:Ultrasonography; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D012709:Serum Albumin; D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid; D002784:Cholesterol