Your browser doesn't support javascript.
loading
Further decompensation in cirrhosis: Results of a large multicenter cohort study supporting Baveno VII statements.
D'Amico, Gennaro; Zipprich, Alexander; Villanueva, Càndid; Sordà, Juan Antonio; Morillas, Rosa Maria; Garcovich, Matteo; García Retortillo, Montserrat; Martinez, Javier; Calès, Paul; D'Amico, Mario; Dollinger, Matthias; García-Guix, Marta; Gonzalez Ballerga, Esteban; Tsochatzis, Emmanuel; Cirera, Isabel; Albillos, Agustìn; Roquin, Guillaume; Pasta, Linda; Colomo, Alan; Daruich, Jorge; Canete, Nuria; Boursier, Jérôme; Dallio, Marcello; Gasbarrini, Antonio; Iacobellis, Angelo; Gobbo, Giulia; Merli, Manuela; Federico, Alessandro; Svegliati Baroni, Gianluca; Pozzoni, Pietro; Addario, Luigi; Chessa, Luchino; Ridola, Lorenzo; Garcia-Tsao, Guadalupe.
Afiliación
  • D'Amico G; Gastroenterology Unit, Department of Medicine, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
  • Zipprich A; Gastroenterology Unit, Department of Medicine, Clinica La Maddalena, Palermo, Italy.
  • Villanueva C; Department of Internal Medicine IV, Jena University Hospitals, Am Klinikum 1, Jena, Germany.
  • Sordà JA; Department of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Morillas RM; Hepatology Section, Gastroenterology Division, Medicine Department, Hospital de Clínicas San Martín, Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
  • Garcovich M; Department of Medicine, Liver Unit, Hospital Germans Trias I Pujol, Badalona, Spain.
  • García Retortillo M; Department of Liver and Digestive Health, Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK.
  • Martinez J; Department of Medicine and Translational Surgery, Internal Medicine and Gastroenterology, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Calès P; Liver Section, Gastroenterology Department, Hospital del Mar. Hospital del Mar Research Institute, Barcelona, Spain.
  • D'Amico M; Department of Gastroenterology and Instituto Ramón y Cajal De Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal and University of Alcalá, Madrid, Spain.
  • Dollinger M; Gastroenterology and Digestive Oncology, Hôpital Universitaire d'Angers, Angers, France.
  • García-Guix M; Gastroenterology Unit, Department of Medicine, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
  • Gonzalez Ballerga E; Interventional Radiology Unit, Department of Radiology, Ospedale Civico Benfratelli, Palermo, Italy.
  • Tsochatzis E; Department of Medicine I (Gastroenterology, Hepatology, Diabetology & Nephrology), Klinikum Landshut, Landshut, Germany.
  • Cirera I; Department of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Albillos A; Hepatology Section, Gastroenterology Division, Medicine Department, Hospital de Clínicas San Martín, Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
  • Roquin G; Department of Liver and Digestive Health, Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK.
  • Pasta L; Liver Section, Gastroenterology Department, Hospital del Mar. Hospital del Mar Research Institute, Barcelona, Spain.
  • Colomo A; Department of Gastroenterology and Instituto Ramón y Cajal De Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal and University of Alcalá, Madrid, Spain.
  • Daruich J; Gastroenterology and Digestive Oncology, Hôpital Universitaire d'Angers, Angers, France.
  • Canete N; Gastroenterology Unit, Department of Medicine, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
  • Boursier J; Department of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Dallio M; Hepatology Section, Gastroenterology Division, Medicine Department, Hospital de Clínicas San Martín, Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
  • Gasbarrini A; Liver Section, Gastroenterology Department, Hospital del Mar. Hospital del Mar Research Institute, Barcelona, Spain.
  • Iacobellis A; Gastroenterology and Digestive Oncology, Hôpital Universitaire d'Angers, Angers, France.
  • Gobbo G; Department of Hepato-Gastroenterology, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  • Merli M; Department of Medicine and Translational Surgery, Internal Medicine and Gastroenterology, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Federico A; Department of Gastroenterology and Endoscopy, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
  • Svegliati Baroni G; Internal Medicine Unit, Department of Medicine, IRCCS Policlinico San Donato, Milano, Italy.
  • Pozzoni P; Gastroenterology and Hepatology Unit, Department of Translational and Precision Medicine, Università Sapienza, Roma, Italy.
  • Addario L; Department of Hepato-Gastroenterology, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  • Chessa L; Liver Injury and Transplant Unit, Department of Medicine, Polytechnic University of Marche, Ancona, Italy.
  • Ridola L; Hepatology Unit, Department of General Medicine, PO Alessandro Manzoni, ASST Lecco, Lecco, Italy.
  • Garcia-Tsao G; Hepatology Unit, Department of Gastroenterology, Cardarelli Hospital, Naples, Italy.
Hepatology ; 79(4): 869-881, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-37916970
BACKGROUND AND AIMS: The prognostic weight of further decompensation in cirrhosis is still unclear. We investigated the incidence of further decompensation and its effect on mortality in patients with cirrhosis. APPROACH AND RESULTS: Multicenter cohort study. The cumulative incidence of further decompensation (development of a second event or complication of a decompensating event) was assessed using competing risks analysis in 2028 patients. A 4-state model was built: first decompensation, further decompensation, liver transplant, and death. A cause-specific Cox model was used to assess the adjusted effect of further decompensation on mortality. Sensitivity analyses were performed for patients included before or after 1999. In a mean follow-up of 43 months, 1192 patients developed further decompensation and 649 died. Corresponding 5-year cumulative incidences were 52% and 35%, respectively. The cumulative incidences of death and liver transplant after further decompensation were 55% and 9.7%, respectively. The most common further decompensating event was ascites/complications of ascites. Five-year probabilities of state occupation were 24% alive with first decompensation, 21% alive with further decompensation, 7% alive with a liver transplant, 16% dead after first decompensation without further decompensation, 31% dead after further decompensation, and <1% dead after liver transplant. The HR for death after further decompensation, adjusted for known prognostic indicators, was 1.46 (95% CI: 1.23-1.71) ( p <0.001). The significant impact of further decompensation on survival was confirmed in patients included before or after 1999. CONCLUSIONS: In cirrhosis, further decompensation occurs in ~60% of patients, significantly increases mortality, and should be considered a more advanced stage of decompensated cirrhosis.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Várices Esofágicas y Gástricas / Trasplante de Hígado Límite: Humans Idioma: En Revista: Hepatology Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Várices Esofágicas y Gástricas / Trasplante de Hígado Límite: Humans Idioma: En Revista: Hepatology Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos