Prognostic value of quantitative liver function tests in viral cirrhosis: a prospective study.
OBJECTIVE
Widespread application of quantitative liver function tests as a prognostic tool is controversial. In this study we assessed the predictivity of serial evaluations of galactose elimination capacity (GEC) and the monoethylglycinexylidide (MEGX) test on survival in viral cirrhosis, and secondarily we compared these tests with Child-Turcotte-Pugh (CTP) and Model for End Stage Liver Disease (MELD) scores.


METHODS
In a cohort of 35 patients with viral cirrhosis, GEC and MEGX were evaluated every 6 months for 24 months and compared with CTP and MELD scores at the same time intervals. The end points were patient death or liver transplantation.


RESULTS
Statistically significant differences between dead/transplanted patients and survivors were found for basal values of GEC, MEGX, CTP and MELD. Receiver-operating characteristics curves of CTP and MELD scores showed a higher prognostic accuracy than GEC and MEGX. On multivariate analysis, neither GEC nor MEGX were independent predictors of survival. Repeated-measures analysis of GEC and MEGX did not increase the prognostic accuracy of these tests and did not add useful prognostic information on patient outcome during the following 6 months.


CONCLUSIONS
Our data suggest that neither single nor repeated determinations of GEC and MEGX are superior to CTP and MELD scores in predicting prognosis of patients with viral cirrhosis.
Addario
Luigi
L
Unità Operativa Complessa di Epatologia, Azienda Ospedaliera A. Cardarelli, Napoli, Italy.
Scaglione
Giuseppe
G
Tritto
Giovanni
G
Di Costanzo
Giovan Giuseppe
GG
De Luca
Massimo
M
Lampasi
Filippo
F
Galeota Lanza
Alfonso
A
Picciotto
Francesco P
FP
Tartaglione
Maria Teresa
MT
Utech
Wanda
W
Macr
Michela
M
Giannelli
Eduardo
E
Ascione
Antonio
A
D000328:Adult; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D005690:Galactose; D006525:Hepatitis, Viral, Human / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D008111:Liver Function Tests / Q000379:methods*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index
D008012:Lidocaine; C001173:monoethylglycinexylidide; D005690:Galactose