title: Serum albumin and platelet count but not portal pressure are predictive of death in patients with Child-Pugh A hepatitis C virus-related cirrhosis.
abstract: OBJECTIVE
  The presence of esophageal varices has been reported to be a prognostic factor in patients with compensated hepatitis viral C induced cirrhosis. We studied the prognostic value of hepatic venous pressure gradient in addition to epidemiological and clinical parameters in these patients.
  
  
  METHODS
  Among patients with Child-Pugh A hepatitis C induced cirrhosis, prospectively followed in two Parisian centres, 100 had measurement of occluded and free hepatic venous pressures. We evaluated hepatic venous pressures as a predictive factor of death by Cox models (survival) and Fine and Gray models (liver-deaths).
  
  
  RESULTS
  Median hepatic occluded pressure and gradient were 21.5 (15-24) and 13 mm Hg (9-15), respectively. The median duration of follow-up was 85 months (range: 70-112); 38 deaths or liver transplantation were registered. Hepatic venous pressure gradient was not significantly related to survival in the studied population but as a continuous variable was predictive of death from liver disease. On multivariable analysis serum albumin <40 g/L and platelet count <90,000 /mm(3) were the only selected prognostic factors.
  
  
  CONCLUSIONS
  Hepatic venous pressure gradient has a limited value for assessing the prognosis of patients with Child-Pugh A hepatitis C virus induced cirrhosis; prognosis is accurately predicted by serum albumin and platelet count.
authors.affiliation: Service d'Hépato-gastroentérologie, Hôpital Jean Verdier, Assistance Publique, Hôpitaux de Paris, Bondy, France. pierre.nahon@jvr.ap-hop-paris.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Nahon
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ganne-Carrié
authors.forename: Françoise
authors.initials: F
authors.lastname: Degos
authors.forename: Karine
authors.initials: K
authors.lastname: Nahon
authors.forename: Jacques
authors.initials: J
authors.lastname: Paries
authors.forename: Véronique
authors.initials: V
authors.lastname: Grando
authors.forename: Cendrine
authors.initials: C
authors.lastname: Chaffaut
authors.forename: Corinne
authors.initials: C
authors.lastname: Njapoum
authors.forename: Christos
authors.initials: C
authors.lastname: Christidis
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Trinchet
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.forename: Michel
authors.initials: M
authors.lastname: Beaugrand
mesh_terms: D000368:Aged; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D017082:Portal Pressure; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis*; D016019:Survival Analysis
chemical_list: D012709:Serum Albumin