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Natural history of hepatitis B virus–related cirrhotic patients hospitalized to control ascites
Author(s) -
Kim Seung Up,
Han KwangHyub,
Nam Chung Mo,
Park Jun Yong,
Kim Do Young,
Chon Chae Yoon,
Ahn Sang Hoon
Publication year - 2008
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2008.05510.x
Subject(s) - medicine , ascites , gastroenterology , hepatorenal syndrome , decompensation , cirrhosis , hepatic encephalopathy , spontaneous bacterial peritonitis , creatinine , hepatocellular carcinoma , hepatitis b virus , gastrointestinal bleeding , immunology , virus
Background and Aim: Few studies have assessed the natural history of hepatitis B virus (HBV)–related cirrhotic ascites. We investigated the natural history of patients with HBV‐related cirrhotic ascites hospitalized to control ascites and determined their prognosis, including survival rates and prognostic factors affecting survival. Methods: Between January 1996 and December 2005, 203 consecutive patients with HBV‐related cirrhotic ascites were followed for a median of 80.7 months (range, 15–149) after their first significant ascitic decompensation that required hospitalization. Results: The mean age of all patients was 52.6 years. Male gender predominated (male/female, 138/65). A subgroup analysis of 165 patients who had ascitic decompensation as their first episode of hepatic decompensation revealed that gastrointestinal variceal bleeding developed after a median interval of 8 months following ascitic decompensation in 31 (18.8%) patients, hepatic encephalopathy occurred at 9 months in 53 (32.1%), spontaneous bacterial peritonitis appeared at 12.7 months in 24 (14.5%), hepatorenal syndrome occurred at 8.1 months in five (3%), and hepatocellular carcinoma was observed at 21.2 months in 10 (6.1%). The overall median survival was 12.4 months. The 1‐ and 3‐year survival rates were 50.7 and 18.7%. The prognostic factors that independently correlated with survival at the time of ascitic decompensation were Child–Pugh classification B/C ( P = 0.030), serum white blood cell (WBC; P = 0.035), serum creatinine (Cr; P = 0.039), serum sodium (Na; P = 0.010), and antiviral therapy ( P = 0.040). Conclusions: The prognosis of HBV‐related cirrhotic patients with ascitic decompensation is poor. Child–Pugh class, serum WBC/Cr/Na, and antiviral therapy primarily influenced survival.