Lack of prognostic usefulness of hepatic venous pressures and hemodynamic values in a select group of patients with severe alcoholic cirrhosis.
OBJECTIVE
Prognostic assessment of patients with alcoholic cirrhosis is still controversial. A prospective study was performed to evaluate hemodynamic values as prognostic factors of death in a group of patients with severe alcoholic cirrhosis.


METHODS
From January, 1991 to February, 1993, a total of 87 admitted patients were prospectively studied. Measurements of the hepatic venous pressure gradient and cardiac output were performed in all patients. The mean follow-up was 35 months (range 1-76 months).


RESULTS
During this period, 56 patients (63% at 5 yr) died. The hepatic venous pressure gradient and cardiac output were not significantly different between the two groups. Using univariate analysis, only age and bilirubin concentration were different between those patients who lived and those who died. Cox regression analysis showed that age, encephalopathy, bilirubin concentration. prothrombin time, and Child-Pugh score were the only prognostic factors.


CONCLUSIONS
Measurement of the hepatic venous pressure gradient is not helpful in the prognostic assessment in a select group of patients with severe alcoholic cirrhosis.
Deltenre
Pierre
P
Laboratoire d'Hémodynamique Splanchnique et de Biologie Vasculaire, INSERM-481 and Service d'Hépatologie, Hôpital Beaujon, Clichy, France.
Rufat
Pierre
P
Hillaire
Sophie
S
Elman
Annie
A
Moreau
Richard
R
Valla
Dominique
D
Lebrec
Didier
D
D001663:Bilirubin / Q000097:blood; D002302:Cardiac Output; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012720:Severity of Illness Index; D014690:Venous Pressure
D001663:Bilirubin