A prognostic model for predicting survival in cirrhosis with ascites.
OBJECTIVE
Parameters evaluating renal function and systemic hemodynamics are of prognostic significance in cirrhosis with ascites but are rarely used in the evaluation of survival of these patients. The aim of the current study was to develop a prognostic model to estimate survival of patients with cirrhosis and ascites.


METHODS
216 Cirrhotic patients admitted to hospital for the treatment of ascites were evaluated. Thirty-two demographic, clinical and laboratory variables, including parameters assessing liver and renal function and systemic hemodynamics, were analyzed as predictive factors of survival by using a Cox regression model.


RESULTS
Four variables had independent prognostic value: renal water excretion, as assessed by measuring diuresis after water load, mean arterial pressure, Child-Pugh class, and serum creatinine. According to these features a prognostic index was calculated that allows to estimate survival in patients with cirrhosis and ascites. The model accurately predicted survival in an independent series of 84 patients with cirrhosis and ascites.


CONCLUSIONS
A prognostic model that uses four easily available variables and predicts prognosis in cirrhotic patients with ascites has been developed. This model may be useful in the evaluation of patients with ascites for liver transplantation.
Fernández-Esparrach
G
G
Liver Unit, Institut de Malalties Digestives, Hospital Clínic, IDIBAPS, Barcelona, Spain.
Sánchez-Fueyo
A
A
Ginès
P
P
Uriz
J
J
Quintó
L
L
Ventura
P J
PJ
Cárdenas
A
A
Guevara
M
M
Sort
P
P
Jiménez
W
W
Bataller
R
R
Arroyo
V
V
Rodés
J
J
D001201:Ascites / Q000401:mortality*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011379:Prognosis; D012189:Retrospective Studies