Prognostic Factors predicting in advanced liver disease [LEFT]SHORT REPORT
* Platelet count <88,000 is associated with the presence of esophagogastric varices OV. A large prospective 1study is needed to verify and validate these findings and may allow identification of a group of patients who would most benefit from endoscopic screening for varices.
* The platelet count/spleen diameter ratio is the only parameter which is independently associated with the presence of OV, and its negative predictive value is reproducible. Its use is of value even in the subgroup of patients with compensated disease, and it is also cost effective
* Ultrasonography is a useful aid in establishing their prognosis. Men with dilation of the portal vein, splenomegaly, or both, form a group with a significantly higher risk of death
* Survival was analyzed according to Cox's model. Six parameters were able to predict survival (albumin, bilirubin, liver volume, prothrombin activity, cholesterol, varices). However, step-wise Cox regression analysis identified only four variables that independently correlated with survival: albumin, bilirubin, cholesterol, and liver volume
* Base-line serum cholesterol levels lower than 100 mg/dl identify a subgroup of Child-C cirrhotic patients with high mortality risk within a 2-year follow-up. The prognostic importance of cholesterolemia may also be deduced by the significant correlation with other well-established indicators of survival
Best wishes
Dr Philip Hardo[/left] |