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Prognostic indicators of survival in patients with cirrhosis and esophageal varices, without previous bleeding.
Am J Gastroenterol. 1989 Jul; 84(7):717-22.AJ

Abstract

Sixty-one patients with cirrhosis with varices without previous bleeding were admitted to our Department over a period of 2 yr. Fifty had alcoholic cirrhosis. Child-Turcotte-Pugh class was A in 11 patients, B in 30, and C in 20. Varices were F1 in 18, and F2-F3 in 43. During follow-up of up to 40 months, one patient was lost to follow-up and 22 patients died, seven of gastrointestinal bleeding and 15 of liver failure. The probability of death from any cause was significantly related to Child-Turcotte-Pugh class, ascites, encephalopathy, s-albumin, s-bilirubin, prothrombin index, and galactose elimination capacity. Independent prognostic variables according to Cox's model resulted s-albumin, s-bilirubin, encephalopathy, and varices. Considering only patients who died from liver failure, survival was univariately related to the same determinants, whereas the Cox's model individuated s-bilirubin, s-albumin, ascites, and galactose elimination capacity as independent prognostic indicators. Considering only patients who died from gastrointestinal bleeding no Cox model could be performed due to the small number of deaths. In patients with F1 varices, the probability of death from liver failure was 5 times higher than that from gastrointestinal bleeding; in patients with F2-F3 varices, liver failure and gastrointestinal bleeding each accounted for approximately half of the deaths. These data could become useful when programming a clinical trial of prophylaxis which considers reduction in mortality as the main end-point.

Authors+Show Affiliations

Department of Clinical Medicine, University of Padua, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2787099

Citation

Merkel, C, et al. "Prognostic Indicators of Survival in Patients With Cirrhosis and Esophageal Varices, Without Previous Bleeding." The American Journal of Gastroenterology, vol. 84, no. 7, 1989, pp. 717-22.
Merkel C, Bolognesi M, Angeli P, et al. Prognostic indicators of survival in patients with cirrhosis and esophageal varices, without previous bleeding. Am J Gastroenterol. 1989;84(7):717-22.
Merkel, C., Bolognesi, M., Angeli, P., Noventa, F., Caregaro, L., Sacerdoti, D., & Gatta, A. (1989). Prognostic indicators of survival in patients with cirrhosis and esophageal varices, without previous bleeding. The American Journal of Gastroenterology, 84(7), 717-22.
Merkel C, et al. Prognostic Indicators of Survival in Patients With Cirrhosis and Esophageal Varices, Without Previous Bleeding. Am J Gastroenterol. 1989;84(7):717-22. PubMed PMID: 2787099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic indicators of survival in patients with cirrhosis and esophageal varices, without previous bleeding. AU - Merkel,C, AU - Bolognesi,M, AU - Angeli,P, AU - Noventa,F, AU - Caregaro,L, AU - Sacerdoti,D, AU - Gatta,A, PY - 1989/7/1/pubmed PY - 1989/7/1/medline PY - 1989/7/1/entrez SP - 717 EP - 22 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 84 IS - 7 N2 - Sixty-one patients with cirrhosis with varices without previous bleeding were admitted to our Department over a period of 2 yr. Fifty had alcoholic cirrhosis. Child-Turcotte-Pugh class was A in 11 patients, B in 30, and C in 20. Varices were F1 in 18, and F2-F3 in 43. During follow-up of up to 40 months, one patient was lost to follow-up and 22 patients died, seven of gastrointestinal bleeding and 15 of liver failure. The probability of death from any cause was significantly related to Child-Turcotte-Pugh class, ascites, encephalopathy, s-albumin, s-bilirubin, prothrombin index, and galactose elimination capacity. Independent prognostic variables according to Cox's model resulted s-albumin, s-bilirubin, encephalopathy, and varices. Considering only patients who died from liver failure, survival was univariately related to the same determinants, whereas the Cox's model individuated s-bilirubin, s-albumin, ascites, and galactose elimination capacity as independent prognostic indicators. Considering only patients who died from gastrointestinal bleeding no Cox model could be performed due to the small number of deaths. In patients with F1 varices, the probability of death from liver failure was 5 times higher than that from gastrointestinal bleeding; in patients with F2-F3 varices, liver failure and gastrointestinal bleeding each accounted for approximately half of the deaths. These data could become useful when programming a clinical trial of prophylaxis which considers reduction in mortality as the main end-point. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/2787099/Prognostic_indicators_of_survival_in_patients_with_cirrhosis_and_esophageal_varices_without_previous_bleeding_ L2 - http://www.diseaseinfosearch.org/result/2658 DB - PRIME DP - Unbound Medicine ER -