1-Year Survey of Patients with Advanced Liver Cirrhosis: Prognostic Value of Clinical and Laboratory Indexes Identified by the Cox Regression Model

Abstract

Ferro D, Saliola M, Quintarelli C, Alessandri C, Basili S, Cordova C, Bonavita MS, Violi F. 1-Year survey of patients with advanced liver cirrhosis. Prognostic value of clinical and laboratory indexes identified by the Cox regression model. Scand J Gastroenterol 1992;27:852-856.

The relation between coagulation indexes and survival rate was studied and analyzed in 46 patients with advanced liver cirrhosis (grade B and C Child-Pugh Classification), during a follow-up of 1 year. Twenty-four patients (52%) died of liver failure or fatal haemorrhage within 12 months of follow-up. Prothrombin activity, fibrinogen, fibrin(ogcn) degradation products, prekallikrein and factor VII. serum bilirubin. and the degree of liver insufficiency, scored by Child-Pugh classification, proved to be significantly correlated with survival by univariate analysis. A multivariate survival analysis (Cox regression model) disclosed two variables, prekallikrein and factor VII, that predicted survival. The rate ratios of death increased to 2.8 and 7.6 with values of prekallikrein <26% and factor VII <39%, respectively. This study shows that some simple laboratory tests exploring the clotting system may identify patients with poor prognosis in severe liver failure.

Key Words:

• Factor VII
• liver cirrhosis
• prekallikrein
• prognostic value