TY  - JOUR
A1  - Bothou, Christina
A1  - Rüschenbaum, Sabrina
A1  - Kubesch, Alica
A1  - Quenstedt, Leonie
A1  - Schwarzkopf, Katharina
A1  - Welsch, Christoph
A1  - Zeuzem, Stefan
A1  - Welzel, Tania Mara
A1  - Lange, Christian Markus
T1  - Anemia and systemic inflammation rather than arterial circulatory dysfunction predict decompensation of liver cirrhosis
T2  - Journal of Clinical Medicine
N2  - Background: While systemic inflammation is recognized as playing a central role in the pathogenesis of organ failures in patients with liver cirrhosis, less is known about its relevance in the development of classical hepatic decompensation. Aim: To characterize the relationship between systemic inflammation, hemodynamics, and anemia with decompensation of liver cirrhosis. Methods: This is a post-hoc analysis of a cohort study of outpatients with advanced liver fibrosis or cirrhosis. Results: Analysis included 338 patients of whom 51 patients (15%) were hospitalized due to decompensation of liver cirrhosis during a median follow-up time of six months. In univariate analysis, active alcoholism (p = 0.002), model of end-stage liver disease (MELD) score (p = 0.00002), serum IL-6 concentration (p = 0.006), heart rate (p = 0.03), low arterial blood pressure (p < 0.05), maximal portal venous flow (p = 0.008), and low hemoglobin concentration (p < 0.00001) were associated with hospitalization during follow-up. Multivariate analysis revealed an independent association of low hemoglobin (OR = 0.62, 95% CI = 0.51–0.78, p = 0.001) and serum IL-6 concentration (OR = 1.02, 95% CI = 1.01–1.04, p = 0.03)—but not of hemodynamic parameters—with hepatic decompensation. An inverse correlation between hemoglobin concentration and portal venous flow (R = −0.362, p < 0.0001) was detected for the non-hospitalized patients. Accuracy of baseline hemoglobin levels for predicting hospitalization (AUC = 0.84, p < 0.000001) was high. Conclusion: Anemia and systemic inflammation, rather than arterial circulatory dysfunction, are strong and independent predictors of hepatic decompensation in outpatients with liver cirrhosis.
KW  - portal hypertension
KW  - ascites
KW  - acute-on-chronic liver failure
KW  - decompensated liver cirrhosis
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55573
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-555731
SN  - 2077-0383
VL  - 9
IS  - (5), 1263
PB  - MDPI
CY  - Basel
ER  -