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Compensated cirrhosis: Natural history and prognostic factors

✍ Scribed by Pere Ginés; Enrique Quintero; Vicente Arroyo; Josep Terés; Miguel Bruguera; Antoni Rimola; Joan Caballería; Joan Rodés; Ciril Rozman


Book ID
102848347
Publisher
John Wiley and Sons
Year
1987
Tongue
English
Weight
724 KB
Volume
7
Category
Article
ISSN
0270-9139

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✦ Synopsis


To investigate the natural history of compensated cirrhosis, 293 consecutive patients without previous major complications (ascites, jaundice, encephalopathy or gastrointestinal hemorrhage) were studied in terms of morbidity (probability of developing decompensated cirrhosis during follow-up) and survival. Patients were diagnosed by liver histology between 1968 and 1980. Median follow-up was 63 months. Decompensation of cirrhosis was considered when a patient first developed one of the major complications of the disease. Ten years after diagnosis, the probability of developing decompensated cirrhosis and the survival probability rate were 58 and 47%, respectively. A multivariate survival analysis (Cox's regression model) using clinical, biochemical and histological data obtained at diagnosis disclosed seven factors that predicted prognosis: serum bilirubin; serum y-globulin concentration; hepatic stigmata; prothrombin time; sex; age, and alkaline phosphatase. According to the contribution of each one of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. The predicting value of this index was validated by a split sample testing technique.


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