Hepatic venous pressure gradient can predict the development of hepatocellular carcinoma and hyponatremia in decompensated alcoholic cirrhosis.
OBJECTIVE
Portal hypertension is closely associated with serious complications of cirrhosis, which contribute to bad prognosis. Hepatocellular carcinoma (HCC) and low serum sodium (SNa) are manifestations of end-stage liver disease and are associated with poor survival in decompensated cirrhosis patients. We aimed to determine the relationship between hepatic venous pressure gradient (HVPG) and the development of HCC or low SNa in decompensated alcoholic cirrhosis patients.


METHODS
Child-Pugh scores, Model for End-Stage Liver Disease scores, and HVPG at baseline, and the development of HCC or low SNa (SNa <130 mEq/l) during follow-up were analyzed prospectively in 170 patients with decompensated alcoholic cirrhosis from December 1999 to January 2008 (mean follow-up period of 33.9+/-27.9 months). The predictive value of different risk factors for the development of HCC and low SNa and survival were investigated.


RESULTS
Twenty-four patients developed HCC during the follow-up period. In the multivariate analysis, only baseline HVPG greater than 15 mmHg was an independent predictive factor for the development of HCC (relative risk=1.128, P<0.05) and which showed a significantly shorter time for the development of HCC on the Kaplan-Meier analysis. Twenty patients developed low SNa during follow-up. Initial HVPG was also an independent predictive factor for the new development of low SNa in the multivariate analysis (relative risk=1.169, P<0.05) and which also showed significantly shorter times for the development of low SNa on the Kaplan-Meier analysis.


CONCLUSIONS
In decompensated alcoholic cirrhosis, HVPG may be a useful predictive factor for the development of HCC and low SNa.
Kim
Moon Young
MY
Departments of Internal Medicine and Institute of Lifelong Health, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju, South Korea.
Baik
Soon Koo
SK
Yea
Chang Jin
CJ
Lee
Il Young
IY
Kim
Hye Jung
HJ
Park
Kyong Won
KW
Kim
Hearn Kook
HK
Suk
Ki Tae
KT
Kim
Jae Woo
JW
Kim
Hyun Soo
HS
Kwon
Sang Ok
SO
Cha
Seung Hwan
SH
Kim
Young Ju
YJ
Koh
Sang Baek
SB
Chang
Sei Jin
SJ
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000503:physiopathology; D007010:Hyponatremia / Q000209:etiology*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014690:Venous Pressure / Q000502:physiology