Comparison of hepatic venous pressure gradient and two models of end-stage liver disease for predicting the survival in patients with decompensated liver cirrhosis

Ki Tae Suk, Chang Hoon Kim, Seung Ha Park, Ho Taik Sung, Jong Young Choi, Kwang Hyub Han, So Hyung Hong, Dae Yong Kim, Jai Hoon Yoon, Yeon Soo Kim, Gwang Ho Baik, Jin Bong Kim, Dong Joon Kim

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Abstract

Goals: We evaluated the efficacy of initial and follow-up hepatic venous pressure gradient (HVPG), models of end-stage liver disease (MELD), and MELD-Na for predicting the survival of patients with decompensated liver cirrhosis (LC). Background: MELD with/without Na score and HVPG have been important predictors of mortality in patients with LC. Study: Between January 2006 and 2011, a total of 57 patients with decompensated LC, all of whom underwent >2 HVPG measurements for the confirmation of propranolol dosing, were enrolled. MELD and MELD-Na scores were calculated on the day of HVPG measurement. The prognostic accuracy of the initial and follow-up HVPG, MELD, and MELD-Na were analyzed, and independent factors for mortality were evaluated. Results: Ten patients (17.5%) died from LC. Initial HVPG (0.883), initial MELD-Na (0.877), follow-up HVPG (0.829), and follow-up MELD-Na (0.802) showed good area under the receiver operating characteristic curve scores in predicting 1-year mortality. In predicting 2-year mortality, only follow-up HVPG (0.821, cut-off value 18 mm Hg) showed good score. Overall area under the receiver operating characteristic curves (initial and follow-up) were 0.843 and 0.864 in HVPG, 0.721 and 0.674 in MELD, and 0.762 and 0.715 in MELD-Na, respectively. In the Cox regression analysis, only follow-up HVPG (P=0.02; odds ratio, 1.11) was associated with mortality. Conclusions: The efficacy of HVPG for predicting mortality is excellent compared with that of MELD or MELD-Na. Therefore, aside from the confirmation of adequate propranolol dosing, HVPG may be needed for predicting the survival of patients with decompensated LC.

Original languageEnglish
Pages (from-to)880-886
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume46
Issue number10
DOIs
Publication statusPublished - 2012 Nov 1

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End Stage Liver Disease
Venous Pressure
Liver Cirrhosis
Survival
Liver
Mortality
Propranolol
ROC Curve

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Suk, Ki Tae ; Kim, Chang Hoon ; Park, Seung Ha ; Sung, Ho Taik ; Choi, Jong Young ; Han, Kwang Hyub ; Hong, So Hyung ; Kim, Dae Yong ; Yoon, Jai Hoon ; Kim, Yeon Soo ; Baik, Gwang Ho ; Kim, Jin Bong ; Kim, Dong Joon. / Comparison of hepatic venous pressure gradient and two models of end-stage liver disease for predicting the survival in patients with decompensated liver cirrhosis. In: Journal of Clinical Gastroenterology. 2012 ; Vol. 46, No. 10. pp. 880-886.
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abstract = "Goals: We evaluated the efficacy of initial and follow-up hepatic venous pressure gradient (HVPG), models of end-stage liver disease (MELD), and MELD-Na for predicting the survival of patients with decompensated liver cirrhosis (LC). Background: MELD with/without Na score and HVPG have been important predictors of mortality in patients with LC. Study: Between January 2006 and 2011, a total of 57 patients with decompensated LC, all of whom underwent >2 HVPG measurements for the confirmation of propranolol dosing, were enrolled. MELD and MELD-Na scores were calculated on the day of HVPG measurement. The prognostic accuracy of the initial and follow-up HVPG, MELD, and MELD-Na were analyzed, and independent factors for mortality were evaluated. Results: Ten patients (17.5{\%}) died from LC. Initial HVPG (0.883), initial MELD-Na (0.877), follow-up HVPG (0.829), and follow-up MELD-Na (0.802) showed good area under the receiver operating characteristic curve scores in predicting 1-year mortality. In predicting 2-year mortality, only follow-up HVPG (0.821, cut-off value 18 mm Hg) showed good score. Overall area under the receiver operating characteristic curves (initial and follow-up) were 0.843 and 0.864 in HVPG, 0.721 and 0.674 in MELD, and 0.762 and 0.715 in MELD-Na, respectively. In the Cox regression analysis, only follow-up HVPG (P=0.02; odds ratio, 1.11) was associated with mortality. Conclusions: The efficacy of HVPG for predicting mortality is excellent compared with that of MELD or MELD-Na. Therefore, aside from the confirmation of adequate propranolol dosing, HVPG may be needed for predicting the survival of patients with decompensated LC.",
author = "Suk, {Ki Tae} and Kim, {Chang Hoon} and Park, {Seung Ha} and Sung, {Ho Taik} and Choi, {Jong Young} and Han, {Kwang Hyub} and Hong, {So Hyung} and Kim, {Dae Yong} and Yoon, {Jai Hoon} and Kim, {Yeon Soo} and Baik, {Gwang Ho} and Kim, {Jin Bong} and Kim, {Dong Joon}",
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Comparison of hepatic venous pressure gradient and two models of end-stage liver disease for predicting the survival in patients with decompensated liver cirrhosis. / Suk, Ki Tae; Kim, Chang Hoon; Park, Seung Ha; Sung, Ho Taik; Choi, Jong Young; Han, Kwang Hyub; Hong, So Hyung; Kim, Dae Yong; Yoon, Jai Hoon; Kim, Yeon Soo; Baik, Gwang Ho; Kim, Jin Bong; Kim, Dong Joon.

In: Journal of Clinical Gastroenterology, Vol. 46, No. 10, 01.11.2012, p. 880-886.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of hepatic venous pressure gradient and two models of end-stage liver disease for predicting the survival in patients with decompensated liver cirrhosis

AU - Suk, Ki Tae

AU - Kim, Chang Hoon

AU - Park, Seung Ha

AU - Sung, Ho Taik

AU - Choi, Jong Young

AU - Han, Kwang Hyub

AU - Hong, So Hyung

AU - Kim, Dae Yong

AU - Yoon, Jai Hoon

AU - Kim, Yeon Soo

AU - Baik, Gwang Ho

AU - Kim, Jin Bong

AU - Kim, Dong Joon

PY - 2012/11/1

Y1 - 2012/11/1

N2 - Goals: We evaluated the efficacy of initial and follow-up hepatic venous pressure gradient (HVPG), models of end-stage liver disease (MELD), and MELD-Na for predicting the survival of patients with decompensated liver cirrhosis (LC). Background: MELD with/without Na score and HVPG have been important predictors of mortality in patients with LC. Study: Between January 2006 and 2011, a total of 57 patients with decompensated LC, all of whom underwent >2 HVPG measurements for the confirmation of propranolol dosing, were enrolled. MELD and MELD-Na scores were calculated on the day of HVPG measurement. The prognostic accuracy of the initial and follow-up HVPG, MELD, and MELD-Na were analyzed, and independent factors for mortality were evaluated. Results: Ten patients (17.5%) died from LC. Initial HVPG (0.883), initial MELD-Na (0.877), follow-up HVPG (0.829), and follow-up MELD-Na (0.802) showed good area under the receiver operating characteristic curve scores in predicting 1-year mortality. In predicting 2-year mortality, only follow-up HVPG (0.821, cut-off value 18 mm Hg) showed good score. Overall area under the receiver operating characteristic curves (initial and follow-up) were 0.843 and 0.864 in HVPG, 0.721 and 0.674 in MELD, and 0.762 and 0.715 in MELD-Na, respectively. In the Cox regression analysis, only follow-up HVPG (P=0.02; odds ratio, 1.11) was associated with mortality. Conclusions: The efficacy of HVPG for predicting mortality is excellent compared with that of MELD or MELD-Na. Therefore, aside from the confirmation of adequate propranolol dosing, HVPG may be needed for predicting the survival of patients with decompensated LC.

AB - Goals: We evaluated the efficacy of initial and follow-up hepatic venous pressure gradient (HVPG), models of end-stage liver disease (MELD), and MELD-Na for predicting the survival of patients with decompensated liver cirrhosis (LC). Background: MELD with/without Na score and HVPG have been important predictors of mortality in patients with LC. Study: Between January 2006 and 2011, a total of 57 patients with decompensated LC, all of whom underwent >2 HVPG measurements for the confirmation of propranolol dosing, were enrolled. MELD and MELD-Na scores were calculated on the day of HVPG measurement. The prognostic accuracy of the initial and follow-up HVPG, MELD, and MELD-Na were analyzed, and independent factors for mortality were evaluated. Results: Ten patients (17.5%) died from LC. Initial HVPG (0.883), initial MELD-Na (0.877), follow-up HVPG (0.829), and follow-up MELD-Na (0.802) showed good area under the receiver operating characteristic curve scores in predicting 1-year mortality. In predicting 2-year mortality, only follow-up HVPG (0.821, cut-off value 18 mm Hg) showed good score. Overall area under the receiver operating characteristic curves (initial and follow-up) were 0.843 and 0.864 in HVPG, 0.721 and 0.674 in MELD, and 0.762 and 0.715 in MELD-Na, respectively. In the Cox regression analysis, only follow-up HVPG (P=0.02; odds ratio, 1.11) was associated with mortality. Conclusions: The efficacy of HVPG for predicting mortality is excellent compared with that of MELD or MELD-Na. Therefore, aside from the confirmation of adequate propranolol dosing, HVPG may be needed for predicting the survival of patients with decompensated LC.

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U2 - 10.1097/MCG.0b013e31825f2622

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