A prognostic model for predicting survival in cirrhosis with ascites

Background/Aims: Parameters evaluating renal function and systemic hemodyna mics are of prognostic significance in cirrhosis with ascites but are rarel y used in the evaluation of survival of these patients. The aim of the curr ent study was to develop a prognostic model to estimate survival of patient s with cirrhosis and ascites. Methods: 216 Cirrhotic patients admitted to hospital for the treatment of a scites were evaluated. Thirty-two demographic, clinical and laboratory vari ables, including parameters assessing liver and renal function and systemic hemodynamics, were analyzed as predictive factors of survival by using a C ox regression model. Results: Four variables had independent prognostic value: renal water excre tion, as assessed by measuring diuresis after water load, mean arterial pre ssure, Child-Pugh class, and serum creatinine, According to these features a prognostic index was calculated that allows to estimate survival in patie nts with cirrhosis and ascites, The model accurately predicted survival in an independent series of 84 patients with cirrhosis and ascites. Conclusion: A prognostic model that uses four easily available variables an d predicts prognosis in cirrhotic patients,vith ascites has been developed, This model may be useful in the evaluation of patients with ascites for li ver transplantation. (C) 2001 European Association for the Study of the Liver. Published by Else vier Science B.V. All rights reserved.