Comparison of the Model for End-stage Liver Disease and hepatic venous pressure gradient for predicting survival in patients with decompensated liver cirrhosis

Lee, Sung Hoa; Park, Seung Ha; Kim, Go Woon; Lee, Woojin; Hong, Won‐Kee; Ryu, Myeong Shin; Park, Kyu Tae; Lee, Min Young; Lee, Chan Woo; Kim, Jin Ho; Kim, Yong Mook; Kim, Sung Jung; Baik, Gwang Ho; Kim, Jin Bong; Kim, Dong Joon

doi:10.3350/kjhep.2009.15.3.350

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…Furthermore, comparison studies between HVPG and MELD score in patients with DC showed different results in the ability to predict long-term mortality. 6 14 15 16 Suk, et al 15 suggested that HVPG in predicting mortality may be more useful than MELD, while other authors showed no additional effect of HVPG on MELD score. 14 16 Our study showed that the discriminative ability of HVPG to predict 1-year, 2-year, and overall mortality was useful, although it was not significantly different from that of the MELD score.…”

Section: Discussionmentioning

confidence: 99%

“… 12 Several studies have found that HVPG values above 16 mm Hg or 18 mm Hg are an important predictor of poor outcome in DC. 2 6 15 In these studies, determining the prognostic value of HVPG was performed at the time of the first manifestation of decompensation. Similarly, we found that an HVPG of 17 mm Hg was the best discriminative cutoff value for the prediction of long-term mortality risk in patients with DC.…”

Section: Discussionmentioning

confidence: 99%

“… 3 4 However, it cannot fully reflect the prognostic impacts of portal hypertensive complications such as ascites, hepatic encephalopathy or VH in those patients and can be also affected by body fluid status, muscle mass, sex, and age. 5 6 7 8 …”

Section: Introductionmentioning

confidence: 99%

“…In fact, recent studies comparing HVPG and MELD have shown different results. 6 14 15 16 However, these results were not classified based on ascites and VH according to D'Amico, et al 17 Recently, a study by Zipprich, et al 14 on survival analysis using HVPG suggested two new stages for decompensated patients, redefining stage 3 as VH without ascites and stage 4 as ascites irrespective to VH.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic Venous Pressure Gradient Predicts Long-Term Mortality in Patients with Decompensated Cirrhosis

et al. 2016

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PurposeThe present study aimed to investigate the role of hepatic venous pressure gradient (HVPG) for prediction of long-term mortality in patients with decompensated cirrhosis.Materials and MethodsClinical data from 97 non-critically-ill cirrhotic patients with HVPG measurements were retrospectively and consecutively collected between 2009 and 2012. Patients were classified according to clinical stages and presence of ascites. The prognostic accuracy of HVPG for death, survival curves, and hazard ratios were analyzed.ResultsDuring a median follow-up of 24 (interquartile range, 13-36) months, 22 patients (22.7%) died. The area under the receiver operating characteristics curves of HVPG for predicting 1-year, 2-year, and overall mortality were 0.801, 0.737, and 0.687, respectively (all p<0.01). The best cut-off value of HVPG for predicting long-term overall mortality in all patients was 17 mm Hg. The mortality rates at 1 and 2 years were 8.9% and 19.2%, respectively: 1.9% and 11.9% with HVPG ≤17 mm Hg and 16.2% and 29.4% with HVPG >17 mm Hg, respectively (p=0.015). In the ascites group, the mortality rates at 1 and 2 years were 3.9% and 17.6% with HVPG ≤17 mm Hg and 17.5% and 35.2% with HVPG >17 mm Hg, respectively (p=0.044). Regarding the risk factors for mortality, both HVPG and model for end-stage liver disease were positively related with long-term mortality in all patients. Particularly, for the patients with ascites, both prothrombin time and HVPG were independent risk factors for predicting poor outcomes.ConclusionHVPG is useful for predicting the long-term mortality in patients with decompensated cirrhosis, especially in the presence of ascites.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepatic Venous Pressure Gradient Predicts Long-Term Mortality in Patients with Decompensated Cirrhosis

et al. 2016

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“…Lee et al10 measured the HVPG in 136 patients with decompensated cirrhosis and found that it was not a significant predictor of mortality. To determine the predictive nature of the HVPG, prospective studies with a broad group of patients (e.g., etiology, sex, and geographic region) are needed.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the hepatic venous pressure gradient and first variceal hemorrhage in patients with cirrhosis: a multicenter retrospective study in Korea

et al. 2012

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Background/AimsVariceal hemorrhage is one of the major complications of cirrhosis and is associated with significant mortality and morbidity. The development of gastroesophageal varices and variceal hemorrhage is the most direct consequence of portal hypertension. Correlations between the hepatic venous pressure gradient (HVPG) and first variceal hemorrhage were examined.MethodsPatients with cirrhosis who underwent HVPG measurement between July 2009 and September 2010 were enrolled (n=535). All patients underwent esophagogastroduodenoscopy to enable the evaluation of gastroesophageal varices.ResultsThe HVPG for all patients was 16.46±7.05 mmHg (mean±SD), and was significantly higher among those with first variceal hemorrhage than in those without it. The HVPG was significantly correlated with both Child-Turcotte-Pugh (r=0.488, P<0.001) and Model for End-stage Liver Disease (r=0.478, P<0.001) scores. An HVPG value of 11 mmHg was predictive of first variceal hemorrhage with a sensitivity of 92.4% and a specificity of 27.7%.ConclusionsThe HVPG was higher in patients with first variceal hemorrhage than in those without it.

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Evaluation of portal hypertension by real‐time shear wave elastography in cirrhotic patients

Kim

Jeong

Sohn

et al. 2015

Liver International

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Comparison of the Model for End-stage Liver Disease and hepatic venous pressure gradient for predicting survival in patients with decompensated liver cirrhosis

Cited by 3 publications

References 19 publications

Hepatic Venous Pressure Gradient Predicts Long-Term Mortality in Patients with Decompensated Cirrhosis

Hepatic Venous Pressure Gradient Predicts Long-Term Mortality in Patients with Decompensated Cirrhosis

Relationship between the hepatic venous pressure gradient and first variceal hemorrhage in patients with cirrhosis: a multicenter retrospective study in Korea

Evaluation of portal hypertension by real‐time shear wave elastography in cirrhotic patients

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