title: Clinicopathological forms and prognostic index in Budd-Chiari syndrome.
abstract: BACKGROUND
  A recent study in patients with Budd-Chiari syndrome showed the value of a prognostic index including age, Pugh score, ascites and serum creatinine. Surgical portosystemic shunt did not appear to improve survival.
  
  
  OBJECTIVE
  To validate these findings in an independent sample; to evaluate a classification into three forms according to the presence of features of acute injury, chronic lesions, or both of them (types I, II or III, respectively); and to assess whether taking into account this classification would alter our previous conclusions.
  
  
  METHODS
  Multivariate Cox model survival analysis, first on 69 new patients; second, on these 69 and 54 previous patients, all diagnosed since 1985.
  
  
  RESULTS
  Previous prognostic index had a significant prognostic value (P<0.0001) which was further improved by taking into account type III form (P<0.001). Type III form was associated with the poorest outcome. No significant impact of surgical shunting on survival was disclosed.
  
  
  CONCLUSIONS
  The prognosis of Budd-Chiari syndrome can be based on age, Pugh score, ascites, serum creatinine and the presence of features indicating acute injury superimposed on chronic lesions (type III form). The idea that surgical shunting has no significant impact on survival is reinforced by these findings.
authors.affiliation: Service d'Hépatologie, Hôpital Beaujon, Clichy, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Langlet
authors.forename: Sylvie
authors.initials: S
authors.lastname: Escolano
authors.forename: Dominique
authors.initials: D
authors.lastname: Valla
authors.forename: Delphine
authors.initials: D
authors.lastname: Coste-Zeitoun
authors.forename: Cecile
authors.initials: C
authors.lastname: Denie
authors.forename: Alain
authors.initials: A
authors.lastname: Mallet
authors.forename: Victor-Georges
authors.initials: VG
authors.lastname: Levy
authors.forename: Dominique
authors.initials: D
authors.lastname: Franco
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Vinel
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Didier
authors.initials: D
authors.lastname: Lebrec
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Hay
authors.forename: Guy
authors.initials: G
authors.lastname: Zeitoun
mesh_terms: D000293:Adolescent; D000328:Adult; D006502:Budd-Chiari Syndrome / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011170:Portasystemic Shunt, Surgical; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis