Liver-to-abdominal area ratio for predicting the in-hospital mortality in advanced liver cirrhosis

ABSTRACT

Objectives: To identify the value of liver-to-abdominal area ratio (LAAR) score for predicting the in-hospital mortality in advanced cirrhotic patients.

Methods: All cirrhotic patients with Child-Pugh class B or C who were admitted between July 2012 and June 2014 and underwent abdominopelvic CT scans were considered in this retrospective observational study. The association of LAAR with in-hospital death was calculated. Receiver operating characteristic curve analysis was performed. The area under curve (AUC) was calculated.

Results: In the overall analysis of 128 cirrhotic patients with Child-Pugh class B or C, LAAR score was significantly associated with the risk of in-hospital death (p = 0.012). The AUC of LAAR score for predicting the in-hospital mortality was 0.764 (p < 0.0001). The best cut-off value was 0.29 with a sensitivity of 75% and a specificity of 73.33%. In the subgroup analysis of 37 patients with Child-Pugh class C, LAAR score was significantly associated with the risk of in-hospital death (p = 0.008). The AUC of LAAR score was 0.821. The best cut-off value was 0.29 with a sensitivity of 85.71% and a specificity of 80%. In the subgroup analysis of 80 patients with moderate-severe ascites, LAAR score was not significantly associated with the risk of in-hospital death (p = 0.072). The AUC of LAAR score was 0.684 (p = 0.0158). The best cut-off value was 0.29 with a sensitivity of 75% and a specificity of 63.89%.

Conclusion: LAAR score might be effective for predicting the in-hospital death of advanced cirrhosis.

KEYWORDS:

• Liver cirrhosis
• prognosis
• LAAR
• Child-Pugh class
• risk
• hospital mortality

Acknowledgments

This work was partially presented as a poster at the Asian Pacific Association for the Study of Liver (APASL) Single Topic Conference (STC) 2016 – 6th HBV Conference.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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Funding

This paper was not funded.