PROGNOSTIC FACTORS FOR LONG-TERM SURVIVAL IN CIRRHOTIC-PATIENTS AFTERTHE FIRST EPISODE OF LIVER DECOMPENSATION

Background/aim. Prognostic studies on cirrhosis are needed since sever al attempts to obtain better survival predictors than the empirically derived Child-Pugh's score have failed. Methods, Fourhundred and ninet y-four consecutive irt-patients with cirrhosis at the first episode of decompensation (ascites, jaundice, encephalopathy) and/or of digestiv e haemorrhage from ruptured oesophageal varices were followed from adm ission (1983-1989) to 1993, studying the relationship between 26 progn ostic variables and survival. Three prognostic models were constructed rising Cox's regression model and the Receiver Operating Characterist ic (ROC) analysis was used to compare their predictive ability. Result s, During follow-up 351 patients died (median cumulative survival 1.82 years). Child-Pugh's score (explicative variable of the first Cox's m odel), albumin and encephalopathy among the 5 Child-Pugh's variables ( second model), and oesophageal varices haemorrhage and 3 biochemical i ndexes among the 7 significant variables on univariate analysis (third model) correlated with survival. The area under the ROC curve of the first model did not significantly differ from that for the other 2 mod els. Conclusions. The Child-Pugh's score is still the best and simples t index for assessing the prognosis of liver cirrhosis.