Longitudinal assessment of prognostic factors for patients with hepatorenal syndrome in a tertiary center
Journal
Hepatology International
Journal Volume
4
Journal Issue
2
Pages
507-510
Date Issued
2010
Author(s)
Abstract
Introduction: Hepatorenal syndrome (HRS) is one of the serious complications in patients with advanced cirrhosis and ascites. In tertiary centers, most patients were classified as having type 1 HRS for their rapid progressive diseases. However, no significant predictors have been assessed previously for patients with type 1 HRS. In addition to the initial model of end-stage liver disease (MELD) scores and biochemistry parameters, we want to further investigate the prognostic importance of changes in MELD scores and biochemistry parameters over time for patients with type 1 HRS. Materials and methods: Data from type 1 HRS patients were incorporated, including their demographic, clinical progression, all recording biochemical parameters, therapeutic methods, and outcomes. Results: A total of 103 patients were included in our study. According to the definition of the International Ascites Club, 67 patients (or 65%) had type 1 HRS whereas 36 (or 35%) had type 2 HRS. According to the multivariate COX proportional hazards regression model, either initial biochemistry parameters or MELD scores were not significantly associated with prognosis. By time-dependent proportional hazards model, each point elevated in creatinine (CRE) and total bilirubin (TBI) levels during the admission increased mortality risk by 29 and 4%, respectively. Increasing albumin level during the admission showed its protective value. Changes in MELD score simple during the admission, which were calculated by CRE and TBI [3.8 × log (bilirubin (mg/dl)] + 9.6 × log [Creatinine (mg/dl) + 6.43], were significant predictor for patients with type 1 HRS. Conclusion: In patients with type 1 HRS, changes in TBI, CRE, and albumin level during the admission were associated with prognosis. Changes in MELD score simple is superior to initial and changes in MELD scores to predict prognosis in patients with type 1 HRS. ? 2010 Asian Pacific Association for the Study of the Liver.
SDGs
Other Subjects
albumin; bilirubin; creatinine; article; biochemistry; demography; disease course; female; hepatorenal syndrome; hospital admission; human; liver transplantation; longitudinal study; major clinical study; male; mortality; priority journal; prognosis; proportional hazards model; scoring system; tertiary health care
Type
journal article