Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Mortality risk according to different characteristics of liver decompensation in cirrhosis

A study in the latest issue of the American Journal of Gastroenterology prospectively evaluates mortality risk according to different clinical characteristics of first episode of liver decompensation in cirrhotic patients.

News image

The occurrence of decompensation marks a crucial turning point in the course of cirrhosis.

Dr Savino Bruno and colleagues from Italy assessed the risk of mortality according to the clinical characteristics of first decompensation, considering also the impact of acute-on-chronic liver failure.

The team conducted a prospective nationwide inception cohort study in Italy.

Decompensation was defined by the presence of ascites, either overt or detected by ultrasonography, gastroesophageal variceal bleeding, and hepatic encephalopathy.

The researchers defined acute-on-chronic liver failure according to the Asian Pacific Association for the Study of the Liver criteria.

Multivariable Cox proportional hazards regression was used to analyze the risk of failure liver transplantation.

A total of 490 consecutive cirrhotic patients fulfilled the study criteria.

The doctors identified acute-on-chronic liver failure in 59 patients.

Among the remaining 431 patients, ascites were found in 330 patients as overt ascites and in 73 as ultrasonography ascites.

The cumulative incidence of failure after 3 years in patients with overt ascites was 41%
American Journal of Gastroenterology

Gastroesophageal variceal bleeding was observed in 77 patients, and hepatic encephalopathy in 30 patients.

The researchers noted that after a median follow-up of 33 months, 24 patients underwent liver transplantation and 125 died.

The cumulative incidence of failure after 1, 2, and 3 years was, respectively, 28%, 53%, and 62% in patients with acute-on-chronic liver failure, and 10%, 18%, and 25% in patients with ultrasonography ascites.

The cumulative incidence of failure after 1, 2, and 3 years in patients with overt ascites was 17%, 31%, and 41%, respectively.

The cumulative incidence of failure after 1, 2, and 3 years in patients with gastroesophageal variceal bleeding.was 8%, 12%, and 24% in patients.

Dr Bruno's team commented, "Acute-on-chronic liver failure is responsible for a relevant proportion of first decompensation in cirrhotic patients and is associated with the poorest outcome."

"Patients with ultrasonography ascites do not have a negligible mortality rate and require clinical monitoring similar to that of patients with overt ascites."

Am J Gastroenterol 2013; 108:1112–1122
12 July 2013

Go to top of page Email this page Email this page to a colleague

 21 September 2014

Advanced search
 19 September 2014 
Adhesions in abdominal and pelvic surgery
 19 September 2014 
Repeat colonoscopy among US Medicare
 19 September 2014 
Progression to liver cancer in HCV-infected Veterans
 18 September 2014 
Patient improvement following sacral neuromodulation
 18 September 2014 
Autoimmune diseases in functional gastrointestinal disorders
 18 September 2014 
New diagnostic score for hepatic steatosis
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Management of complex colon polyps
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes
 04 September 2014 
Colectomy rates for refractory ulcerative colitis
 04 September 2014 
Infliximab prevents long-term Crohn’s disease recurrence
 04 September 2014 
Histological recovery with gluten-free diet in celiac disease
 03 September 2014 
Predictors of response in Crohn's disease
 03 September 2014 
Diagnosis of atrophic gastritis
 03 September 2014 
Safety of reinitiation of infliximab therapy
 02 September 2014 
SSRIs and depression in Hep C
 02 September 2014 
Bariatric surgery for obesity
 02 September 2014 
Eosinophilic esophagitis in adults
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 01 September 2014 
Genetic variants in alcoholic liver disease
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 28 August 2014 
Predictoris of C. diff in out-patients
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease
 26 August 2014 
NAFLD and gastroesophageal reflux symptoms
 26 August 2014 
Adalimumab-treated patients with ulcerative colitis
 26 August 2014 
Wound healing after abdominoperineal resection
 25 August 2014 
Surgical management of rectourethral fistulas
 25 August 2014 
Biomarker analysis in biopsies for ulcerative colitis
 25 August 2014 
Ileocolic resection in Crohn's disease

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us