Prospective Assessment of Liver Function by an Enzymatic Liver Function Test to Estimate Short-Term Survival in Patients with Liver Cirrhosis.
Acetamides
Breath Tests
Carbon Dioxide
/ analysis
Carbon Isotopes
Cohort Studies
Creatinine
/ metabolism
Cytochrome P-450 CYP1A2
/ metabolism
End Stage Liver Disease
/ enzymology
Female
Humans
Liver Cirrhosis
/ enzymology
Liver Function Tests
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prospective Studies
Severity of Illness Index
Survival Rate
End-stage liver disease
LiMAx
Liver function test
MELD
Risk assessment
Survival
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
02
08
2018
accepted:
29
10
2018
pubmed:
9
11
2018
medline:
26
3
2019
entrez:
9
11
2018
Statut:
ppublish
Résumé
MELD attempts to objectively predict the risk of mortality of patients with liver cirrhosis and is commonly used to prioritize organ allocation. Despite the usefulness of the MELD, updated metrics could further improve the accuracy of estimates of survival. To assess and compare the prognostic ability of an enzymatic We prospectively investigated liver function of 268 chronic liver failure patients without hepatocellular carcinoma. Primary study endpoint was liver-related death within 3 months of follow-up. Prognostic values were calculated using Cox proportional hazards and logistic regression analysis. The Cox proportional hazard model indicated that LiMAx (p < 0.001) and serum creatinine values (p < 0.001) were the significant parameters independently associated with the risk of liver failure-related death. Logistic regression analysis revealed LiMAx and serum creatinine to be independent predictors of mortality. Areas under the receiver-operating characteristic curves for MELD (0.86 [0.80-0.92]) and for a combined score of LiMAx and serum creatinine (0.83 [0.76-0.90]) were comparable. Apart from serum creatinine levels, enzymatic liver function measured by LiMAx was found to be an independent predictor of short-term mortality risk in patients with liver cirrhosis. A risk score combining both determinants allows reliable prediction of short-term prognosis considering actual organ function. Trial Registration Number (German Clinical Trials Register) # DRKS00000614.
Sections du résumé
BACKGROUND
MELD attempts to objectively predict the risk of mortality of patients with liver cirrhosis and is commonly used to prioritize organ allocation. Despite the usefulness of the MELD, updated metrics could further improve the accuracy of estimates of survival.
AIMS
To assess and compare the prognostic ability of an enzymatic
METHODS
We prospectively investigated liver function of 268 chronic liver failure patients without hepatocellular carcinoma. Primary study endpoint was liver-related death within 3 months of follow-up. Prognostic values were calculated using Cox proportional hazards and logistic regression analysis.
RESULTS
The Cox proportional hazard model indicated that LiMAx (p < 0.001) and serum creatinine values (p < 0.001) were the significant parameters independently associated with the risk of liver failure-related death. Logistic regression analysis revealed LiMAx and serum creatinine to be independent predictors of mortality. Areas under the receiver-operating characteristic curves for MELD (0.86 [0.80-0.92]) and for a combined score of LiMAx and serum creatinine (0.83 [0.76-0.90]) were comparable.
CONCLUSIONS
Apart from serum creatinine levels, enzymatic liver function measured by LiMAx was found to be an independent predictor of short-term mortality risk in patients with liver cirrhosis. A risk score combining both determinants allows reliable prediction of short-term prognosis considering actual organ function. Trial Registration Number (German Clinical Trials Register) # DRKS00000614.
Identifiants
pubmed: 30406480
doi: 10.1007/s10620-018-5360-5
pii: 10.1007/s10620-018-5360-5
doi:
Substances chimiques
Acetamides
0
Carbon Isotopes
0
methacetin
13E468TFHP
Carbon Dioxide
142M471B3J
Creatinine
AYI8EX34EU
Cytochrome P-450 CYP1A2
EC 1.14.14.1
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
576-584Références
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