Mean arterial pressure drop is an independent risk factor of death in patients with HBV-related cirrhosis ascites
Liver Disease Diagnosis and Treatment Center of PLA, Bethune International Peace Hospital, Shijiazhuang, China
Department of Neonatology, Bethune International Peace Hospital, Shijiazhuang, China
Turk J Gastroenterol 2017; 28: 26-30
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Key Words: Mean arterial pressure, cirrhosis, ascites, risk factor, predictor of death
Background/Aims: In patients with cirrhosis ascites, mean arterial pressure (MAP) is a credible sign of circulatory dysfunction. There are no studies on the relationship between MAP and long-term prognosis in hepatitis B virus (HBV)-related liver cirrhosis ascites. Therefore, we assessed the association between MAP and prognosis in patients with liver cirrhosis ascites.
Materials and Methods: In total, 110 patients of HBV-related liver cirrhosis ascites were prospectively followed for 5 years. After their admission, the patients underwent laboratory tests and MAP measurements. Multivariate analysis was conducted using backward stepwise Cox proportional hazards regression. Receiver operator characteristic (ROC) curves were used to confirm the best cutoff value of several baseline parameters, including MAP, for predicting death in patients with liver cirrhosis ascites.
Results: In a follow-up period of 5 years, 60 (54.5%) patients survived. MAP (OR 1.176, 95% CI 1.045 to 1.326, p=0.003) was an independent risk factor of death, together with Child–Pugh score (OR 1.204, 95% CI 1.068 to 1.357, p=0.002) and model for end-stage liver disease score (OR 1.297, 95% CI 1.198 to 1.405, p=0.000). The area under the ROC curve of MAP was 0.819 at baseline (95% CI 0.741 to 0.897, p=0.000). A baseline MAP value of ≤83.5 mmHg was an independent risk factor of death.
Conclusion: A decrease in MAP was a valuable predictor of death in patients with HBV-related liver cirrhosis ascites. MAP may be used for determining the prognosis and exploring new treatment measures directed at optimizing the treatment of liver cirrhosis ascites.