473119064

Anemia and systemic inflammation rather than arterial circulatory dysfunction predict decompensation of liver cirrhosis / Christina Bothou, Sabrina Rüschenbaum, Alica Kubesch, Leonie Quenstedt, Katharina Schwarzkopf, Christoph Welsch, Stefan Zeuzem, Tania Mara Welzel, Christian Markus Lange

Bothou, Christina [Verfasser] ; Rüschenbaum, Sabrina,i1988- [Verfasser] ; Kubesch, Alica,i1989- [Verfasser] ; Quenstedt, Leonie [Verfasser] ; Schwarzkopf, Katharina [Verfasser] ; Welsch, Christoph,i1974- [Verfasser] ; Zeuzem, Stefan [Verfasser] ; Welzel, Tania Mara,i1974- [Verfasser] ; Lange, Christian,i1979- [Verfasser]

Background: While systemic inflammation is recognized as playing a central role in the pathogenesis of organ failures in patients with liver cirrhosis, less is known about its relevance in the development of classical hepatic decompensation. Aim: To characterize the relationship between systemic inflammation, hemodynamics, and anemia with decompensation of liver cirrhosis. Methods: This is a post-hoc analysis of a cohort study of outpatients with advanced liver fibrosis or cirrhosis. Results: Analysis included 338 patients of whom 51 patients (15%) were hospitalized due to decompensation of liver cirrhosis during a median follow-up time of six months. In univariate analysis, active alcoholism (p = 0.002), model of end-stage liver disease (MELD) score (p = 0.00002), serum IL-6 concentration (p = 0.006), heart rate (p = 0.03), low arterial blood pressure (p < 0.05), maximal portal venous flow (p = 0.008), and low hemoglobin concentration (p < 0.00001) were associated with hospitalization during follow-up. Multivariate analysis revealed an independent association of low hemoglobin (OR = 0.62, 95% CI = 0.51–0.78, p = 0.001) and serum IL-6 concentration (OR = 1.02, 95% CI = 1.01–1.04, p = 0.03)—but not of hemodynamic parameters—with hepatic decompensation. An inverse correlation between hemoglobin concentration and portal venous flow (R = −0.362, p < 0.0001) was detected for the non-hospitalized patients. Accuracy of baseline hemoglobin levels for predicting hospitalization (AUC = 0.84, p < 0.000001) was high. Conclusion: Anemia and systemic inflammation, rather than arterial circulatory dysfunction, are strong and independent predictors of hepatic decompensation in outpatients with liver cirrhosis.

Journal of Clinical Medicine. - Basel : MDPI, 2012-. - Online-Ressource. - ISSN 2077-0383. - Band 9, Heft 5 (2020), Artikel-ID: 1263

 

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