Predictors of Death in Cirrhosis Include Age, BSA, MELD
Left atrial enlargement, increased heart rate and E/e', and reduced mean BP also predicted death
TUESDAY, Sept. 26, 2017 (HealthDay News) -- For patients with cirrhosis, predictors of death include age, body surface area (BSA), and Model for End-Stage Liver Disease (MELD), according to a study published online Sept. 13 in Hepatology.
Maurizio Cesari, M.D., Ph.D., from the University of Padova in Italy, and colleagues assessed left ventricular geometry, systo/diastolic function, and the main hemodynamic parameters in a series of cirrhotic patients without cardiovascular or pulmonary disease. A total of 115 patients were followed for at least six years after baseline evaluation.
The researchers found that 47 percent of patients died during follow-up. The risk of death was increased in association with age, BSA, MELD, mean arterial pressure, heart rate, cardiac index, systemic vascular resistance index, and the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/e') in univariate analysis. Increased age and left atrial dimension and lower BSA were the strongest predictors of death in a multivariable model including important factors (but not MELD). The main predictors of death were MELD, age, and BSA when MELD was included in the analysis. Increased E/e' and heart rate, as well as reduced mean blood pressure, correlated with poor prognosis in analysis including only cardiovascular parameters.
"In a large cohort of cirrhotic patients and after a long follow-up MELD, age and BSA were the main predictors of death," the authors write.