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Natural history of hepatitis B virus-related cirrhotic patients hospitalized to control ascites

Authors
 Seung Up Kim  ;  Kwang-Hyub Han  ;  Chung Mo Nam  ;  Jun Yong Park  ;  Do Young Kim  ;  Chae Yoon Chon  ;  Sang Hoon Ahn 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.23(11) : 1722-1727, 2008 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2008
MeSH
Adult ; Antiviral Agents/therapeutic use ; Ascites/mortality ; Ascites/therapy ; Ascites/virology* ; Carcinoma, Hepatocellular/virology ; Creatinine/blood ; Disease Progression ; Esophageal and Gastric Varices/virology ; Female ; Gastrointestinal Hemorrhage/virology ; Hepatic Encephalopathy/virology ; Hepatitis B/complications* ; Hepatitis B/mortality ; Hepatitis B/therapy ; Hepatorenal Syndrome/virology ; Hospitalization* ; Humans ; Kaplan-Meier Estimate ; Leukocyte Count ; Liver Cirrhosis/complications ; Liver Cirrhosis/mortality ; Liver Cirrhosis/therapy ; Liver Cirrhosis/virology* ; Liver Neoplasms/virology ; Male ; Middle Aged ; Peritonitis/microbiology ; Peritonitis/virology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Sodium/blood ; Time Factors
Keywords
ascites ; hepatitis B virus ; liver cirrhosis ; natural history ; prognosis ; survival
Abstract
BACKGROUND AND AIM: Few studies have assessed the natural history of hepatitis B virus (HBV)-related cirrhotic ascites. We investigated the natural history of patients with HBV-related cirrhotic ascites hospitalized to control ascites and determined their prognosis, including survival rates and prognostic factors affecting survival.

METHODS: Between January 1996 and December 2005, 203 consecutive patients with HBV-related cirrhotic ascites were followed for a median of 80.7 months (range, 15-149) after their first significant ascitic decompensation that required hospitalization.

RESULTS: The mean age of all patients was 52.6 years. Male gender predominated (male/female, 138/65). A subgroup analysis of 165 patients who had ascitic decompensation as their first episode of hepatic decompensation revealed that gastrointestinal variceal bleeding developed after a median interval of 8 months following ascitic decompensation in 31 (18.8%) patients, hepatic encephalopathy occurred at 9 months in 53 (32.1%), spontaneous bacterial peritonitis appeared at 12.7 months in 24 (14.5%), hepatorenal syndrome occurred at 8.1 months in five (3%), and hepatocellular carcinoma was observed at 21.2 months in 10 (6.1%). The overall median survival was 12.4 months. The 1- and 3-year survival rates were 50.7 and 18.7%. The prognostic factors that independently correlated with survival at the time of ascitic decompensation were Child-Pugh classification B/C (P = 0.030), serum white blood cell (WBC; P = 0.035), serum creatinine (Cr; P = 0.039), serum sodium (Na; P = 0.010), and antiviral therapy (P = 0.040).

CONCLUSIONS: The prognosis of HBV-related cirrhotic patients with ascitic decompensation is poor. Child-Pugh class, serum WBC/Cr/Na, and antiviral therapy primarily influenced survival.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2008.05510.x/abstract
DOI
18717757
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107465
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