Anemia and systemic inflammation rather than arterial circulatory dysfunction predict decompensation of liver cirrhosis
- 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.
Verfasserangaben: | Christina Bothou, Sabrina Rüschenbaum, Alica KubeschORCiDGND, Leonie Quenstedt, Katharina Schwarzkopf, Christoph WelschORCiDGND, Stefan ZeuzemORCiDGND, Tania Mara WelzelGND, Christian Markus Lange |
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URN: | urn:nbn:de:hebis:30:3-555731 |
DOI: | https://doi.org/10.3390/jcm9051263 |
ISSN: | 2077-0383 |
Titel des übergeordneten Werkes (Englisch): | Journal of Clinical Medicine |
Verlag: | MDPI |
Verlagsort: | Basel |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Datum der Veröffentlichung (online): | 26.04.2020 |
Datum der Erstveröffentlichung: | 26.04.2020 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Datum der Freischaltung: | 08.10.2020 |
Freies Schlagwort / Tag: | acute-on-chronic liver failure; ascites; decompensated liver cirrhosis; portal hypertension |
Jahrgang: | 9 |
Ausgabe / Heft: | (5), 1263 |
HeBIS-PPN: | 473119064 |
Institute: | Medizin / Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | Creative Commons - Namensnennung 4.0 |