Varices on computed tomography are surrogate of clinically significant portal hypertension and can predict survival in compensated cirrhosis patients

Dong Ho Lee, Jhii Hyun Ahn, Jin Wook Chung, Young Ju Kim, Seung Whan Cha, Moon Young Kim, Soon Koo Baik

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background and Aim: To investigate prognostic value of varices on computed tomography (CT) and redefine surrogate criteria for clinically significant portal hypertension (CSPH). Methods: We retrospectively enrolled 241 patients with compensated cirrhosis who underwent hepatic venous pressure gradient (HVPG) measurement from 2008 to 2013. Using CT and upper endoscopy findings obtained within 3 months from HVPG measurement, patients were classified into three groups: presence of standard surrogate for CSPH, defined as presence of varices on upper endoscopy and/or splenomegaly associated with thrombocytopenia (Group 1, n = 139); varices on CT without standard surrogate for CSPH (Group 2, n = 41); and free from both (Group 3, n = 61). HVPG value and overall survival (OS) rates were compared among three patient groups. Revised surrogate for CSPH was defined as presence of standard surrogate and/or presence of varices on CT (i.e. both Group 1 and Group 2). Results: Mean HVPG value in Group 2 was significantly higher than that in Group 3 (10.3 mmHg vs 6.5 mmHg, P < 0.001), but significantly lower than that in Group 1 (10.3 mmHg vs 13.1 mmHg, P < 0.001). Seven-year OS rates in Group 2 was similar to those in Group 1 (57.0% vs 62.7%, P = 0.591), but significantly poorer than those in Group 3 (57.0% vs 84.0%, P = 0.015). The presence of revised surrogate for CSPH was a significant predictive factor for OS (P = 0.025, Hazard ratio = 2.71 [1.14–6.45]) on multivariate analysis whereas standard surrogate for CSPH was not (P = 0.849). Conclusion: The presence of varices on CT was a significant sign for CSPH, predicting poor OS outcome in patients with compensated cirrhosis.

Original languageEnglish
Pages (from-to)450-457
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume34
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

Bibliographical note

Funding Information:
conflicts of interest to disclose. Financial support: This research was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI15C2364, HI17C1365, HI15C1532). 1Dong Ho Lee and Jhii-Hyun Ahn equally contributed to this work as co-first authors. 2JinWook Chung and Soon KooBaik contributed equally to this work.

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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