Journal of hepato-biliary-pancreatic sciences · 2015
Hyponatremia: a significant factor in a poor prognosis for cirrhosis with Child A/B after variceal eradication.
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Maruyama Hitoshi, Kondo Takayuki, Sekimoto Tadashi, Kiyono Soichiro, Shimada Taro, Takahashi Masanori, Okugawa Hidehiro, Yokosuka Osamu
Аннотация
BACKGROUND: To identify prognostic factors prospectively in cirrhosis after the eradication of esophageal varices (EV).
METHODS: There were 52 cirrhosis patients (Child-Pugh A 24, B 28) who showed the eradication of EV after the endoscopic sclerotherapy (median observation period, 25.5 months).
RESULTS: Eighteen patients showed a recurrence of EV. The cumulative overall survival rate was 92.2% at 1 year, 70.9% at 3 years, and 47.2% at 5 years. Univariate analysis showed that serum sodium concentration (hazard ratio [HR] 0.724, P = 0.0006), serum aspartate transaminase (HR 1.019, P = 0.0075), serum alanine transaminase (HR 1.025, P = 0.0239), and serum creatinine (HR 11.311, P = 0.044) levels before treatment were significant factors for a poor prognosis. Multivariate analysis revealed that serum sodium concentration (HR 0.711, P = 0.0022) was the only significant factor. The cumulative survival rate was lower in patients with hyponatremia (<135 mEq/l, a best cut-off value; 83.3% at 1 year, and 33.3% at 3 years), than in those without (93.3% at 1 year, 77.3% at 3 years and 47.2% at 5 years).
CONCLUSIONS: Pre-treatment hyponatremia is a significant prognostic factor in cirrhosis with Child A/B after the eradication of EV by the endoscopic sclerotherapy.
METHODS: There were 52 cirrhosis patients (Child-Pugh A 24, B 28) who showed the eradication of EV after the endoscopic sclerotherapy (median observation period, 25.5 months).
RESULTS: Eighteen patients showed a recurrence of EV. The cumulative overall survival rate was 92.2% at 1 year, 70.9% at 3 years, and 47.2% at 5 years. Univariate analysis showed that serum sodium concentration (hazard ratio [HR] 0.724, P = 0.0006), serum aspartate transaminase (HR 1.019, P = 0.0075), serum alanine transaminase (HR 1.025, P = 0.0239), and serum creatinine (HR 11.311, P = 0.044) levels before treatment were significant factors for a poor prognosis. Multivariate analysis revealed that serum sodium concentration (HR 0.711, P = 0.0022) was the only significant factor. The cumulative survival rate was lower in patients with hyponatremia (<135 mEq/l, a best cut-off value; 83.3% at 1 year, and 33.3% at 3 years), than in those without (93.3% at 1 year, 77.3% at 3 years and 47.2% at 5 years).
CONCLUSIONS: Pre-treatment hyponatremia is a significant prognostic factor in cirrhosis with Child A/B after the eradication of EV by the endoscopic sclerotherapy.
Предметные рубрики MeSH
AdultAge FactorsAgedAged, 80 and overBiopsy, NeedleCohort StudiesEndosonographyEsophageal and Gastric VaricesFemaleHumansHyponatremiaImmunohistochemistryKaplan-Meier EstimateLiver CirrhosisLogistic ModelsMaleMiddle AgedMultivariate AnalysisPrognosisProportional Hazards ModelsProspective StudiesROC CurveRisk AssessmentSclerotherapySeverity of Illness IndexSex FactorsTreatment Outcome