PROGNOSTIC VALUE OF FREE-WATER PERITONEAL CLEARANCE IN DECOMPENSATED CIRRHOSIS - A 3-YEAR PROSPECTIVE FOLLOW-UP

Patients, 38, with decompensated cirrhosis were enrolled in a 3 year p rospective follow-up to investigate the long-term prognostic value of free-water peritoneal clearance (FWPC) and intraabdominal pressure (IA P). All patients were;a priori' divided into different subgroups, acco rding to the basal values of FWPC (methylene-blue dilution method) and IAP (direct manometry). Arbitrarily chosen cut-off levels (90 ml/min for FWPC and 17 cm H2O for IAP) were adopted. The cumulative 3 year mo rtality was significantly lower in the subgroup of patients with FWPC above 90 ml/min than in those with FWPC below 90 ml/min (P < 0.05, Kap lan Meier method and log-rank test). No significant difference was fou nd between the cumulated survivals of the subgroups discriminated by m eans of the IAP cut-off. Our results suggest that FWPC has an intrinsi c prognostic value in patients with decompensated cirrhosis. Therefore , FWPC may be helpfully considered in a multivariate prognostic model for the estimate of the individual survivals in ascitic patients. (C) 1997 Elsevier Science Ireland Ltd.