Hepatopulmonary syndrome (HPS) is defined by chronic liver disease, arterial deoxygenation, and widespread intrapulmonary vasodilation.
Mortality is high, however the effect of HPS on survival in patients with cirrhosis is unclear.
In this study, physicians from Austria evaluated 111 patients with cirrhosis.
They used transthoracic contrast echocardiography to detect pulmonary vasodilation, blood gas analysis, and pulmonary function.
In addition, they collected data on 20 clinical characteristics, and recorded survival rates.
|Hepatopulmonary syndrome patients had significantly higher mortality.|
The team found that 24% of patients had HPS.
These patients had significantly higher mortality, compared with patients without HPS. This difference remained, even after adjustment for liver disease severity, and the exclusion of patients who underwent liver transplantation during follow-up.
The physicians identified causes of death as predominantly nonpulmonary and liver-related.
They determined that HPS was an independent predictor of survival, in addition to patient age, Child-Pugh class, and blood urea nitrogen.
Furthermore, mortality correlated with the severity of HPS.
Dr Peter Schenk's team concluded, "The presence of HPS independently worsens prognosis of patients with cirrhosis".
"This should influence patient management and scoring systems and accelerate the evaluation process for liver transplantation".