AMINOPYRINE BREATH TEST IMPROVES LONG-TERM PROGNOSTIC EVALUATION IN PATIENTS WITH ALCOHOLIC CIRRHOSIS IN CHILD CLASS-A AND CLASS-B

In a 4-year survival study, we evaluated the prognostic value of the a minopyrine breath test and the Child-Turcotte-Pugh score in 190 alcoho lic patients. Using aminopyrine breath test results, the patients were stratified into group 1 (aminopyrine breath test >2%), group 2 (1% am inopyrine breath test <2%) and group 3 (aminopyrine breath test <1%). Survival rates at 4 years were 68% in group 1, 35% in group 2 and 17% in group 3. Using the Child-Turcotte-Pugh score, survival rates at 4 y ears were 67% in Child-Turcotte-Pugh class A, 40% in class B and 7% in class C. To assess the value of aminopyrine breath test as an adjunct to Child-Turcotte-Pugh score in prognostic evaluation of patients wit h cirrhosis, two approaches have been used: a regression analysis usin g Cox's proportional hazard model by including the Child-Turcotte-Pugh score and aminopyrine breath test value, and the log-rank test to ass ess the prognostic value of aminopyrine breath test in each Child-Turc otte-Pugh class separately. The regression analysis showed that both p arameters, the Child-Turcotte-Pugh score and the aminopyrine breath te st results, were accepted in the model, suggesting that the aminopyrin e breath test was still significantly related to survival once the Chi ld-Turcotte-Pugh score had been entered into the model. Analysis of th e prognostic value of the aminopyrine breath test in each Child-Turcot te-Pugh class separately indicated, however, that the contribution was negligible in the Child-Turcotte-Pugh class C. In patients in Child-T urcotte-Pugh classes A and B, on the other hand, aminopyrine breath te st results improved prognostic stratification.