The impact and role of hepatic hydrothorax in the prognosis of patients with decompensated cirrhosis: A retrospective propensity score-matched study

Abstract

Background and aimsHepatic Hydrothorax (HH) is one of the complications in patients with decompensated cirrhosis and its impact and role in the prognosis of patients with decompensated cirrhosis are not yet clear. Thus, this study aimed to determine the role of HH in patients with decompensated cirrhosis and the long-term impact on their mortality.Materials and methodsA retrospective study analyzed 624 patients with ascites without pleural effusion in decompensated cirrhosis and 113 patients with HH. Propensity scores were calculated based on eight variables, and the HH and non-HH groups were matched in a 1:1 ratio. The effect and role of HH on the prognosis of patients with decompensated cirrhosis was analyzed using the Kaplan–Meier method and Cox proportional hazards regression model.ResultsA total of 737 patients were included. Out of 113 HH patients, 106 could be matched to 106 non-HH patients. After matching, baseline characteristics were well-balanced. The multifactorial Cox proportional hazards model indicated that hepatic encephalopathy and HH were independent risk factors affecting prognostic survival in patients with decompensated cirrhosis (P < 0.01), with risk ratios and 95% confidence intervals (CI) of 2.073 (95% CI: 1.229–3.494, P < 0.01) and 4.724 (95% CI: 3.287–6.789, P < 0.01), respectively. Prognostic survival was significantly worse in the HH group compared to patients in the non-HH group, with mortality rates of 17.9, 30.1, and 59.4% at 6 months, 1 year, and 2 years in the HH group, compared to 0.9, 3.8, and 5.6% in the non-HH group, respectively. The estimated median survival time was 21 (95% CI: 18–25) months in the HH group and 49 (95% CI: 46–52) months in the non-HH group (P < 0.001).ConclusionHepatic hydrothorax is significantly associated with higher mortality in patients with decompensated cirrhosis and is a highly negligible independent decompensated event affecting their prognosis.

The impact of MELD exception points for hydrothorax on posttransplant mortality: a propensity score-matched analysis

“…Another retrospective study of 100 patients with hepatic hydrothorax showed 30-day and 6-month mortality rates of 19 and 32%, respectively [17]. Comparison of patients with hepatic hydrothorax to a propensity score-matched cohorts of patients with cirrhosis but without hepatic hydrothorax showed that hepatic hydrothorax is an independent risk factor for survival in patients with decompensated cirrhosis [17,18]. Our findings are in line with these previous studies.…”

Risk factors for hepatic hydrothorax in patients with cirrhosis: a clinical retrospective study

“…The occurrence of HH has been reported in 4-16% of patients with cirrhosis. Most patients with HH have ascites in combination, of which 59-85% are right-sided, 12-17% are left-sided, and 2-29% are bilateral (1,(3)(4)(5)(6)(7). There were very few reported cases of HH without ascites (8,9).…”