Abstract | BACKGROUND/AIMS: METHODS: The study comprises the prospective evaluation of 168 consecutive cirrhosis patients presenting an episode of spontaneous bacterial peritonitis. RESULTS:
Hepatocellular carcinoma was diagnosed in 35 out of the 168 (20%) patients included in the study (10 single; 25 advanced tumors). Renal impairment developed in 82 patients. Resolution of infection was achieved in 90% of the cases, the hospital survival being 70%. Renal impairment, advanced tumor stage, albumin, and GGT showed independent prognostic value for hospital mortality. At the end of follow-up 101 patients had died, the 1- and 2-year survival being 36% and 31%, respectively. Four variables independently predicted survival: advanced tumor (OR: 3.9; p=0.00001), renal impairment (OR: 2.1; p=0.00001), bilirubin (OR: 1.6; p=0.02) and creatinine (OR: 1.3; p=0.03). Advanced tumor retained independent predictability in patients surviving hospitalization (OR: 7.5; p=0.0001), the 6-month survival being significantly lower in patients with advanced tumor (12% vs 57%, p<0.00001). CONCLUSION: The prevalence of hepatocellular carcinoma in cirrhotic patients with spontaneous bacterial peritonitis is high, and its presence should be actively sought. Advanced tumor impairs both hospital and long-term survival, and should be considered in the design of future trials.
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Authors | J M Llovet, E Moitinho, M Sala, R Bataller, P Rodríguez-Iglesias, A Castells, J Fernández, R Planas, M Navasa, J Bruix, J Rodés |
Journal | Journal of hepatology
(J Hepatol)
Vol. 33
Issue 3
Pg. 423-9
(Sep 2000)
ISSN: 0168-8278 [Print] Netherlands |
PMID | 11019998
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Bacterial Infections
- Carcinoma, Hepatocellular
(epidemiology, etiology)
- Female
- Hospital Mortality
- Humans
- Liver Cirrhosis
(complications)
- Liver Neoplasms
(epidemiology, etiology)
- Male
- Middle Aged
- Peritonitis
(complications, microbiology)
- Prevalence
- Prognosis
- Survival Analysis
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