World journal of hepatology · 2025
Survival of patients with hepatopulmonary syndrome related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension.
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Rolim Melissa M, Farsoun Liana G, Luna Carlos F, Markman-Filho Brivaldo, Querette Paulo, Lopes Edmundo P, Domingues Ana L
Аннотация
BACKGROUND: The hepatosplenic schistosomiasis (HSS) with portal hypertension can cause vascular complications such as hepatopulmonary syndrome (HPS). HPS increases the risk of mortality in patients with cirrhosis; however, there is no data on the mortality of patients with HSS and HPS.
AIM: To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension.
METHODS: From August 2023 to January 2024, medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed. Survival curves were created using the Kaplan-Meier method, and comparisons were performed using the log-rank test. Cox regression models estimated the hazard ratios (HR).
RESULTS: Overall, data of 113 patients were analyzed; most (55.8%) had HSS and concomitant cirrhosis (HSS/cirrhosis). Meanwhile, HPS was present in 39 (34.5%) patients. Death occurred in 65 patients [57.5%; 95% confidence interval (CI): 48%-67%. The average time to death was lower in those with HPS when compared to those without HPS (3.37 years vs 5.65 years; P = 0.017). According to the cause of liver disease, patients with HSS/cirrhosis died earlier, and their risk of death was twice as high compared with patients with HSS without cirrhosis (HR: 2.17; 95%CI: 1.3-3.60; P = 0.003). Meanwhile, there were no differences when comparing the two groups with and without HPS (HR: 1.01; 95%CI: 0.59-1.73; P = 0.967).
CONCLUSION: Patients with HSS and concomitant cirrhosis had a lower survival rate, but there was no difference in survival regardless of the presence of HPS.
AIM: To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension.
METHODS: From August 2023 to January 2024, medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed. Survival curves were created using the Kaplan-Meier method, and comparisons were performed using the log-rank test. Cox regression models estimated the hazard ratios (HR).
RESULTS: Overall, data of 113 patients were analyzed; most (55.8%) had HSS and concomitant cirrhosis (HSS/cirrhosis). Meanwhile, HPS was present in 39 (34.5%) patients. Death occurred in 65 patients [57.5%; 95% confidence interval (CI): 48%-67%. The average time to death was lower in those with HPS when compared to those without HPS (3.37 years vs 5.65 years; P = 0.017). According to the cause of liver disease, patients with HSS/cirrhosis died earlier, and their risk of death was twice as high compared with patients with HSS without cirrhosis (HR: 2.17; 95%CI: 1.3-3.60; P = 0.003). Meanwhile, there were no differences when comparing the two groups with and without HPS (HR: 1.01; 95%CI: 0.59-1.73; P = 0.967).
CONCLUSION: Patients with HSS and concomitant cirrhosis had a lower survival rate, but there was no difference in survival regardless of the presence of HPS.