Direct Hyperbilirubinemia as a Predictor of Mortality in Patients with Liver Cirrhosis

Abstract

Liver cirrhosis (LC) is the 11th leading cause of death globally, and its prevalence has been increasing in recent decades. 1 Because of the high fatality rate associated with LC, there have been many attempts to identify accurate prognostic models that will help make better clinical decisions, but these attempts have not led to satisfactory results. 2,3 Histopathologic findings and hepatic venous pressure gradient may reflect disease severity, but their clinical use is limited due to their invasiveness. 4 Widely used noninvasive parameters include the Child-Pugh score and Model for End-Stage Liver Disease (MELD) score-the MELD system is noted for its use in liver transplant allocation. 5,6 These two models use serum bilirubin as a component of their prognostic scales. Most previous studies have used total bilirubin (TB), rather than direct bilirubin (DB), as an indicator of bilirubin metabolism. This paper presents a study that focuses on DB and evaluates its relevance in predicting poor outcomes.Lee et al. 7 compared the prognostic performance of DB and TB in patients with LC. They retrospectively assessed 983 patients who were admitted to the hospital during the study period; the patients were divided into two groups: a training set and a validation set. Lee et al. evaluated significance using the C-statistics for survival and compared the performance of MELD score and DB-MELD score (MELD score determined using DB instead of TB). The results showed that the prognostic performance of DB was higher than that of TB, and DB-MELD score showed a higher area under the receiver operating characteristic curve than the MELD score. Moreover, Lee et al. reweighed the

Therapeutic effect of notoginseng saponins before and after fermentation on blood deficiency rats

“…A high level of ALT suggests liver damage ( 67 ). DBIL represents the liver metabolic capacity, acting as an indicator of liver damage, and the level of DBIL is increased in patients with hepatitis and cirrhosis ( 68 ). ALP is released from the liver and bones, and its levels are increased in certain liver diseases and bone disorders ( 69 ).…”

Predictor factor for growth and development status in cholestasis jaundice children, a cross sectional study

“…This impairment can lead to the accumulation of potentially harmful substances in both the liver and bloodstream, resulting in liver damage and reduced formation of IGF-1 and IGF-BP3. 14 Patients with a damaged liver experience a poor prognosis due to a defect in hepatic clearance. 1 In this study, the median value for total bilirubin (7.75 mg/dL) and direct bilirubin (5.88 mg/dL) in normal development status was lower than in suspect development status (10.54 ,g/dL and 7.74 mg/dL).…”