Predictive value of hepatic venous pressure gradient on the prognosis of patients with decompensated liver cirrhosis

Abstract

Abstract: Objective To investigate the role of hepatic venous pressure gradient (HVPG) in the prognosis of patients with decompensated cirrhosis. Methods A total of 51 patients with decompensated cirrhosis admitted to our hospital from September 2016 to December 2020 were selected. The HVPG was measured by vascular intervention. The area under receiver operating characteristic curve (AUROC) method was used to analyze the accuracy of HVPG in predicting prognosis. X-tile software was used to derive optimal cutoff values for continuity variables. The overall survival rate was analyzed by Kaplan-Meier method. A Cox regression model was established to evaluate the risk ratio of independent predictors. Results The value of HVPG in patients with decompensated cirrhosis was 20.68 ± 9.02 mmHg. The AUROC of total mortality predicted by HVPG was 0.729. The overall mortality of patients with decompensated cirrhosis was significantly different. Patients with decompensated cirrhosis with HVPG ≤ 19 mmHg had a significantly lower mortality rate than those with HVPG>19 mmHg (P=0.005). In univariate COX variable analysis, bilirubin, alanine aminotransferase (ALT), Child-Turcotte-Pugh (CTP) score, HVPG (HR: 1.051; 95%CI: 1.093-1112; P=0.026), and model for end-stage liver disease (MELD) score were significantly correlated with long-term mortality in patients with decompensated cirrhosis. In multivariate Cox regression analysis, only HVPG (HR: 1.079; 95% CI: 1.009-1.15; P=0.027) and bilirubin were significantly correlated with long-term mortality. Conclusion HVPG has a good predictive value for the prognosis of patients with decompensated liver cirrhosis.

Key words: Decompensated cirrhosis, Hepatic vein pressure gradient, Prognosis, Survival time

WEI Feng, WANG Jian, SHI Jian, WEI Jue. Predictive value of hepatic venous pressure gradient on the prognosis of patients with decompensated liver cirrhosis[J]. Chinese Hepatolgy, 2023, 28(6): 649-653.

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