Prognosis assessment of cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.
OBJECTIVE
The role of peritoneovenous shunt in the management of refractory ascites has not been clearly established. The aim of this study was to determine readily accessible predictive survival factors in cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.


METHODS
We studied a cohort of 100 cirrhotic patients with refractory ascites who underwent peritoneovenous-shunt placement in a university-based reference hospital.


RESULTS
The estimated median survival of patients after shunt placement was 11 months (95% CI, 7-14 months). Multivariate analysis based on the proportional hazards model disclosed four independent variables associated with poor survival: high Pugh score, nonalcoholic etiology, low ascitic fluid protein concentration, and history of spontaneous bacterial peritonitis.


CONCLUSIONS
Mortality of cirrhotic patients treated with a peritoneovenous shunt can be determined by a prognostic index using four easily available variables. Such a prognostic index, once prospectively validated, could be used as an adjunct in planning treatment of cirrhotic patients with refractory ascites.
Service of Gastroenterology and General Surgery, Hospital de Bellvitge Princeps d'Espanya, Spain.
J
J
Guardiola
X
X
Xiol
J M
JM
Escribá
J M
JM
Castellví
J
J
Castellote
C
C
Baliellas
A
A
Rafecas
L A
LA
Casais
D001201:Ascites / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010536:Peritoneovenous Shunt; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis