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Erschienen in: Digestive Diseases and Sciences 2/2019

07.11.2018 | Original Article

Prospective Assessment of Liver Function by an Enzymatic Liver Function Test to Estimate Short-Term Survival in Patients with Liver Cirrhosis

verfasst von: Maximilian Jara, Tomasz Dziodzio, Maciej Malinowski, Katja Lüttgert, Radoslav Nikolov, Paul Viktor Ritschl, Robert Öllinger, Johann Pratschke, Martin Stockmann

Erschienen in: Digestive Diseases and Sciences | Ausgabe 2/2019

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Abstract

Background

MELD attempts to objectively predict the risk of mortality of patients with liver cirrhosis and is commonly used to prioritize organ allocation. Despite the usefulness of the MELD, updated metrics could further improve the accuracy of estimates of survival.

Aims

To assess and compare the prognostic ability of an enzymatic 13C-based liver function test (LiMAx) and distinct markers of liver function to predict 3-month mortality of patients with chronic liver failure.

Methods

We prospectively investigated liver function of 268 chronic liver failure patients without hepatocellular carcinoma. Primary study endpoint was liver-related death within 3 months of follow-up. Prognostic values were calculated using Cox proportional hazards and logistic regression analysis.

Results

The Cox proportional hazard model indicated that LiMAx (p < 0.001) and serum creatinine values (p < 0.001) were the significant parameters independently associated with the risk of liver failure-related death. Logistic regression analysis revealed LiMAx and serum creatinine to be independent predictors of mortality. Areas under the receiver-operating characteristic curves for MELD (0.86 [0.80–0.92]) and for a combined score of LiMAx and serum creatinine (0.83 [0.76–0.90]) were comparable.

Conclusions

Apart from serum creatinine levels, enzymatic liver function measured by LiMAx was found to be an independent predictor of short-term mortality risk in patients with liver cirrhosis. A risk score combining both determinants allows reliable prediction of short-term prognosis considering actual organ function.
Trial Registration Number (German Clinical Trials Register) # DRKS00000614.
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Metadaten
Titel
Prospective Assessment of Liver Function by an Enzymatic Liver Function Test to Estimate Short-Term Survival in Patients with Liver Cirrhosis
verfasst von
Maximilian Jara
Tomasz Dziodzio
Maciej Malinowski
Katja Lüttgert
Radoslav Nikolov
Paul Viktor Ritschl
Robert Öllinger
Johann Pratschke
Martin Stockmann
Publikationsdatum
07.11.2018
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 2/2019
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5360-5

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