title: Prevalence of hepatopulmonary syndrome in patients with decompensated chronic liver disease and its impact on short-term survival.
abstract: BACKGROUND
  Hepatopulmonary syndrome is reported to occur in 4% to 32% of the patients with chronic liver disease and is associated with poor liver function and shortened patient survival before and after liver transplantation.
  
  
  OBJECTIVE
  To assess the frequency of hepatopulmonary syndrome in Brazilian patients with decompensated chronic liver disease and to investigate its impact on patient survival.
  
  
  METHODS
  One hundred and thirty patients (101 males, mean age 61 +/- 12 years) with decompensated chronic liver disease were evaluated for the presence of hepatopulmonary syndrome. The diagnosis of hepatopulmonary syndrome was considered in the presence of alveolar arterial oxygen gradient of more than 15 mm Hg and of pulmonary vascular dilatation assessed by contrast enhanced echocardiography.
  
  
  RESULTS
  Hepatopulmonary syndrome was observed in 21 (16%) patients. The presence of hepatopulmonary syndrome was significantly associated with severity of liver disease assessed by the MELD (Model for End-Stage Liver Disease) score, but not with in hospital mortality after admission due to decompensated chronic liver disease.
  
  
  CONCLUSIONS
  Hepatopulmonary syndrome occurs in 16% of patients with chronic liver disease and is associated with disease severity according to the MELD score. Short term mortality following decompensation of chronic liver disease was not associated with hepatopulmonary syndrome.
authors.affiliation: Unit of Gastroenterology and Hepatology, Portuguese Hospital of Salvador, Brazil.
authors.forename: Palmireno Pinheiro
authors.initials: PP
authors.lastname: Ferreira
authors.forename: Edmundo José Nasri
authors.initials: EJ
authors.lastname: Camara
authors.forename: Rogério Luis Porto de
authors.initials: RL
authors.lastname: Paula
authors.forename: Cláudio Celestino
authors.initials: CC
authors.lastname: Zollinger
authors.forename: Andréa Ribeiro
authors.initials: AR
authors.lastname: Cavalcanti
authors.forename: Paulo Lisboa
authors.initials: PL
authors.lastname: Bittencourt
mesh_terms: D002908:Chronic Disease; D004452:Echocardiography / Q000379:methods; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007089:Image Enhancement; D008107:Liver Diseases / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016019:Survival Analysis