[Prognostic factors for survival in cirrhosis].
BACKGROUND
Assessment of prognosis in patients with cirrhosis is important so as to plan their management as well as the choice of major procedures. The aim of the present study was to determine the survival rates and to identify indicators associated with shorter life expectancy in Tunisians patients with cirrhosis.


METHODS
This is a retrospective study of patients with cirrhosis admitted during 14-years period. We studied clinical and biochemical characteristics of all patients and the occurrence of decompensation or complication (gastro-intestinal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, hepato-renal syndrome, hepatocellular carcinoma). The overall survival, mortality rate and causes of death were reviewed. Univariate and multivariate analysis was performed on all variables to identify parameters associated with a lower life expectancy.


RESULTS
We studied 85 patients (50 females/35 males) with a mean age of 57 years. Mean follow up was 31 months. The overall survival was 47% at 5 years. With univariate analysis, 13 variables were associated with a poor prognosis: male sex, jaundice, ascites, and decompensation at admission, increased serum gammaglobulin, gammaGT, bilirubine and ASAT levels, Child-Pugh C, occurrence of spontaneous bacterial peritonitis, hepatic encephalopathy, hepato-renal syndrome and hepatocellular carcinoma. With multivariate analysis, 2 variables were independently correlated with survival:male sex and elevated gammaGT.


CONCLUSIONS
In our study, male sex, increased serum gammaGT and gammaglobulin are uncommon parameters that may predict survival in cirrhotic patient. The Child-Pugh score was a good index for assessing the prognosis.
Ennaifer
Rym
R
Service de Gastroentérologie, Centre Hospitalo-Universitaire Habib Thameur.
Ouakaa-Kchaou
Asma
A
BelHadj
Najet
N
Elloumi
Héla
H
Gargouri
Dalila
D
Kochlef
Asma
A
Kilani
Afef
A
Romani
Malika
M
Kharrat
Jamel
J
Ghorbel
Abdeljabbar
A
D000328:Adult; D000368:Aged; D002423:Cause of Death; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008017:Life Expectancy; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014416:Tunisia