ReviewNatural history and prognostic indicators of survival in cirrhosis: A systematic review of 118 studies
Section snippets
Background
Liver transplantation significantly improves the survival and quality of life of patients with end-stage cirrhosis. However, a large proportion of cirrhotic patients still die while on the transplant list because of an insufficient number of donors and because of the lack of an accurate prediction of life expectancy. Although many prognostic models have been proposed in the last two decades to predict mortality in cirrhosis, the Child–Pugh score [1] is by far the most largely used both in
Natural history of cirrhosis
Cirrhosis is the end-stage of every chronic liver disease. Its natural history is characterized by an asymptomatic phase, termed ‘compensated’ cirrhosis followed by a rapidly progressive phase marked by the development of complications of portal hypertension and/or liver dysfunction, termed ‘decompensated cirrhosis’ (Fig. 1). In the compensated phase, portal pressure may be normal or below the threshold level identified for the development of varices or ascites (‘clinically significant portal
Discussion
Prognosis is an essential part of the baseline assessment of any disease. It is not only the basis for the information that a physician provides to the patient, but is also the basis for any decision-making process. However, the applicability of the available prognostic information to the individual patient is frequently unsatisfactory because individual patients are different from the average patient population on which a prognostic estimation is based. Apart from the individual biologic
References (152)
- et al.
A model to predict survival in patients with end-stage liver disease
Hepatology
(2001) - et al.
Assessment of the prognosis of cirrhosis: Child-Pugh versus MELD
J Hepatol
(2005) - et al.
The incidence of esophageal varices in cirrhosis
Gastroenterology
(2001) Evolving consensus in portal hypertension report of the baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension
J Hepatol
(2005)- et al.
A comparison of multivariable mathematical methods for predicting survival–III. Accuracy of predictions in generating and challenge sets
J Clin Epidemiol
(1990) - et al.
High-density lipoprotein cholesterol as an indicator of liver function and prognosis in noncholestatic cirrhotics
Clin Gastroenterol Hepatol
(2005) - et al.
Optimized analysis of recurrent bleeding and death in patients with cirrhosis and esophageal varices. Copenhagen esophageal varices sclerotherapy project
J Hepatol
(1994) - et al.
Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients
Dig Liver Dis
(2000) - et al.
Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites
Gastroenterology
(1988) - et al.
Plasma catecholamine level and portal venous pressure as guides to prognosis in patients with cirrhosis
J Hepatol
(1988)
Indocyanine green intrinsic hepatic clearance as a prognostic index of survival in patients with cirrhosis
J Hepatol
Prognostic value of peritoneoscopic findings in cirrhosis of the liver
Gastrointest Endosc
Predictive value of serum procollagen-III-peptide for the survival of patients with cirrhosis
J Hepatol
Prediction of variceal hemorrhage in cirrhosis: a prospective follow-up study
Gastroenterology
Survival and prognostic indicators in hepatitis B surface antigen-positive cirrhosis of the liver
Gastroenterology
The effects of alcohol use on rebleeding and mortality in patients with alcoholic cirrhosis following variceal haemorrhage
J Hepatol
Prognostic usefulness of hepatic vein catheterization in patients with cirrhosis and esophageal varices
Gastroenterology
Prognostic significance of portal hemodynamics in patients with compensated cirrhosis
J Hepatol
Prognostic variables in patients with cirrhosis and oesophageal varices without prior bleeding
J Hepatol
Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study. The investigators of the European concerted action on Viral Hepatitis (EUROHEP)
J Hepatol
Plasma calprotectin: a new prognostic marker of survival in alcohol-induced cirrhosis
Hepatology
Aminopyrine breath test improves long-term prognostic evaluation in patients with alcoholic cirrhosis in Child classes A and B
J Hepatol
Prognostic value of clotting and fibrinolytic systems in a follow-up of 165 liver cirrhotic patients. CALC Group
Hepatology
The course of galactose elimination capacity in patients with alcoholic cirrhosis: possible use as a surrogate marker for death
Hepatology
Does malnutrition affect survival in cirrhosis? PINC (Policentrica Italiana Nutrizione Cirrosi)
Hepatology
Prognostic value of the galactose test in predicting survival of patients with cirrhosis evaluated for liver transplantation. A prospective multicenter Italian study. AISF Group for the study of liver transplantation. Associazione Italiana per lo Studio del Fegato
J Hepatol
Prognostic value of hepatic venous pressure gradient measurements in alcoholic cirrhosis: a 10-year prospective study
Gastroenterology
Prognostic evaluation of patients with parenchymal cirrhosis. Proposal of a new simple score
J Hepatol
Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients
Gastroenterology
Nutritional and prognostic significance of serum hypothyroxinemia in hospitalized patients with liver cirrhosis
J Hepatol
Prognostic significance of hepatic encephalopathy in patients with cirrhosis
J Hepatol
Prognostic usefulness of ultrasonographic signs of portal hypertension in patients with child-pugh stage a liver cirrhosis
Am J Gastroenterol
Surgery and portal hypertension
Major Probl Clin Surg
Diagnosis of portal hypertension: how and when
A 20-year prospective study of cirrhosis
Br Med J
Compensated cirrhosis: natural history and prognosis
Hepatology
Survival and prognostic indicators in compensated and decompensated cirrhosis
Dig Dis Sci
Natural history of compensated cirrhosis and varices
Clinical and statistical validity of conventional prognostic factors in predicting short-term survival among cirrhotics
Hepatology
Reproducibility of predictor variables from a validated clinical rule
Med Decis Making
Study of the prognosis factors in liver cirrhosis
Med Interne
Prognostic score in liver cirrhosis developed using the Cox's proportional hazard regression model
Ric Clin Lab
A Pugh score of 8 adequately selects patients with parenchymal cirrhosis for liver transplantation
Transpl Int
Survival after a first episode of spontaneous bacterial peritonitis. Prognosis of potential candidates for orthotopic liver transplantation
J Gastroenterol Hepatol
Multivariate analysis of clinical and biological data in cirrhotic patients: application to prognosis
Eur J Clin Invest
Grading scores and survivorship functions in liver cirrhosis: a comparative statistical analysis of various predictive models
Hepatogastroenterology
Prognostic value of indocyanine green and lidocaine kinetics for survival and chronic hepatic encephalopathy in cirrhotic patients following elective end-to-side portacaval shunt
Hepatology
Cited by (2266)
Prehabilitation in patients awaiting liver transplantation
2024, Transplantation ReviewsThe Role of Endoscopy for Primary and Secondary Prophylaxis of Variceal Bleeding
2024, Gastrointestinal Endoscopy Clinics of North AmericaManaging cirrhosis with limited resources: perspectives from sub-Saharan Africa
2024, The Lancet Gastroenterology and HepatologyThe Impact of a Point-of-Care Ultrasound (POCUS) Program to Diagnose and Manage Ascites in Home-based Palliative Care
2024, Journal of the American Medical Directors AssociationInpatient Outcomes of Cirrhosis-related Cachexia in the United States
2024, Gastro Hep AdvancesBeta-blockers and cirrhosis: Striking the right balance
2024, American Journal of the Medical Sciences