Members of the Copenhagen Study Group for Liver Diseases are: Planning and steering committee—C. Gluud, F. Hardt and E. Juhl (Hvidovre University Hospital). Hormone analysis—P. Bennett and S. G. Johnsen (deceased) (Statens Seruminstitut). Statistical analysis—G. Nielsen (Statistical Research Unit, University of Copenhagen). Pathology—P. Christoffersen and H. Poulsen (Hvidovre University Hospital). Clinical investigators—O. Bonnevie, J. Eriksen, C. Gluud, F. Hardt, K. Iversen, E. Juhl, B. B. Knudsen, N. Milman, L. Ranek, T. I. A. Sørensen, H. F. Thomsen, Å. C. Thomsen, N. Tygstrup, P. Wantzin and K. Winkler.
Prognostic indicators in alcoholic cirrhotic men
Article first published online: 5 DEC 2005
Copyright © 1988 American Association for the Study of Liver Diseases
Volume 8, Issue 2, pages 222–227, March/April 1988
How to Cite
Gluud, C., Henriksen, J. H. (1988), Prognostic indicators in alcoholic cirrhotic men. Hepatology, 8: 222–227. doi: 10.1002/hep.1840080205
- Issue published online: 5 DEC 2005
- Article first published online: 5 DEC 2005
- Manuscript Accepted: 6 AUG 1987
- Manuscript Received: 24 JUN 1986
- Danish Medical Research Council, the Ebba Celinder's Foundation, the Johann and Hanne Weiman, née Seedorff's Foundation, the Foundation of 1870, the Borgen Foundation, the Max and Anna Friedmann's Foundation for the Prevention of Disease and the Danish Hospital Foundation for Medical Research, Region of Copenhagen, the Faroe Islands and Greenland
The relationships between portal pressure, liver function and clinical variables on one hand and development of variceal hemorrhage and death on the other were investigated in 58 men with newly diagnosed alcoholic cirrhosis. Portal pressure was determined during hepatic vein catheterization as wedged minus free hepatic vein pressure, and median pressure was 14 mm Hg (range = 3 to 26 mm Hg). Fourteen of 31 patients (45%) had esophageal varices at upper gastrointestinal endoscopy (the size being considered large in nine patients).
During follow-up (median = 31 months; range = 2 to 51 months), 12 patients (21%) developed variceal hemorrhage. Applying Cox's regression analysis, information about previous variceal bleeding (p = 0.0046), large varices at endoscopy (p = 0.012), hepatic vein pressure gradient (p = 0.0056) and indocyanine green clearance (p = 0.038) all contained significant prognostic information regarding development of variceal hemorrhage, even when easily obtained variables with known prognostic information were included [modified Child-Turcotte's criteria and incapacitation index (a weighted sum of days without normal health)].
During follow-up, 17 patients (29%) died. Applying Cox's regression analysis, large varices at endoscopy (p = 0.012) and hepatic vein pressure gradient (p = 0.019) contained significant prognostic information regarding death, in addition to the information contained in the modified Child-Turcotte's criteria and incapacitation index. In conclusion, prediction of prognosis in alcoholic cirrhotic men may be significantly improved by information about size of esophageal varices and level of portal pressure.