Linked Life Data

17520742

Source:http://linkedlifedata.com/resource/pubmed/id/17520742

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2007-10-3
pubmed:abstractText
Hepatic encephalopathy (HE) is an important component of hepatic decompensation, which reduces survival in patients with cirrhosis. The Model for End-Stage Liver Disease (MELD) score has been used to predict survival of patients with cirrhosis. The aims of this study were to determine whether HE is a predictor of survival of patients with cirrhosis and to examine the degree to which HE may add to the survival prediction of MELD. Patients with end-stage liver disease whose data were included in 2 databases were included in the analysis: 223 patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) insertion, and 271 patients hospitalized with hepatic decompensation. In univariate analysis, HE grade 3 or higher was associated with a 3.7-fold (95% confidence interval, 1.9-7.3, P<0.01) increase in the risk of death in the TIPS patients and HE grade 2 or higher was associated 3.9-fold increase (95% confidence interval [95% CI], 2.6-5.7, P<0.01) in hospitalized patients. As expected, MELD and Child-Turcotte-Pugh scores (with and without HE included) were also markedly associated with survival. When HE (grade 2 or higher) and MELD were considered together, HE remained strongly statistically significant in the hospitalized patients (hazard ratio=2.6, 95% CI, 1.7-3.8, P<0.01). The effect became smaller in the TIPS patients (hazard ratio=1.1; 95% CI, 0.7-1.6, P=0.76). In conclusion, this retrospective study demonstrates that HE is an important event in the natural history of cirrhosis that affects subsequent survival of patients. HE may provide additional prognostic information independent of MELD, which warrants prospective validation.
pubmed:grant
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1527-6465
pubmed:author
pubmed:copyrightInfo
Copyright (c) 2007 AASLD.
pubmed:issnType
Print
pubmed:volume
13
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1366-71
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed:year
2007
pubmed:articleTitle
Hepatic encephalopathy as a predictor of survival in patients with end-stage liver disease.
pubmed:affiliation
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. stewart.charmaine@mayo.edu
pubmed:publicationType
Journal Article, Research Support, N.I.H., Extramural