Document Detail


Haemodynamic parameters predicting variceal haemorrhage and survival in alcoholic cirrhosis.
MedLine Citation:
PMID:  9519209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relationship between the various haemodynamic abnormalities observed in cirrhosis and their prognostic value remains unclear. We report haemodynamic measurements on 96 patients with alcoholic cirrhosis (mean Childs-Pugh Score, CPS, 9.0 +/- 0.2, mean age 55.6 +/- 1.0 years) and assess their value in predicting variceal bleeding and death during a mean follow-up of 19.3 +/- 1.5 months. Baseline CPS correlated with hepatic venous pressure gradient (HVPG) (p = 0.001), azygos blood flow (p < 0.05), cardiac index (p < 0.05), and inversely with mean arterial pressure (p < 0.01) and systemic vascular resistance index (p < 0.05). Renal blood flow was not related to any haemodynamic parameter or CPS. Thirty-eight patients died during follow-up, and 16 had a variceal bleed. Death (p = 0.001) and variceal bleeding (p < 0.05) were more likely in patients with HVPG > 16 mmHg than in those with HVPG < 16 mmHg, and variceal bleeding was more likely in patients with HVPG > 12 mmHg (vs. HVPG < 12 mmHg, p < 0.05). HVPG also predicted death and variceal haemorrhage on univariate and multivariate analyses. No other haemodynamic parameter predicted death or bleeding. In alcoholic cirrhosis, severity of liver disease is related to HVPG, collateral blood flow and degree of systemic circulatory abnormalities. HVPG is a useful predictor of survival and variceal bleeding in these patients.
Authors:
A J Stanley; I Robinson; E H Forrest; A L Jones; P C Hayes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  91     ISSN:  1460-2725     ISO Abbreviation:  QJM     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-04-01     Completed Date:  1998-04-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  19-25     Citation Subset:  IM    
Affiliation:
Department of Medicine, Royal Infirmary of Edinburgh, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Pressure
Cardiac Output
Esophageal and Gastric Varices / complications*,  mortality,  physiopathology
Female
Follow-Up Studies
Gastrointestinal Hemorrhage / etiology*,  mortality,  physiopathology
Hemodynamics*
Hepatic Veins / physiopathology
Humans
Liver Cirrhosis, Alcoholic / complications*,  mortality,  physiopathology
Male
Middle Aged
Prognosis
Regional Blood Flow
Regression Analysis
Statistics, Nonparametric
Survival Rate
Vascular Resistance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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