The effects of prognostic factors on transplant and mortality of patients with end-stage liver disease using Markov multistate model
Background: Decompensated cirrhosis patients have a high risk of death which can be considerably reduced with liver transplantation (LT). This study aimed to simultaneously investigate the effect of some patients' characteristics on mortality among those with/without LT and also LT incident. Ma...
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Veröffentlicht in: | Journal of research in medical sciences 2023-01, Vol.28 (1), p.28-28 |
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Sprache: | eng |
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Zusammenfassung: | Background: Decompensated cirrhosis patients have a high risk of death which can be considerably reduced with liver transplantation (LT). This study aimed to simultaneously investigate the effect of some patients' characteristics on mortality among those with/without LT and also LT incident. Materials and Methods: In this historical cohort study, the information from 780 eligible patients aged 18 years or older was analyzed by the Markov multistate model; they had been listed between 2008 and 2014, needed a single organ for initial orthotopic LT, and followed at least for up to 5 years. Results: With a median survival time of 6 (5-8) years, there were 275 (35%) deaths. From 255 (33%) patients who had LT, 55 (21%) subsequently died. Factors associated with a higher risk of mortality and LT occurrence were included: higher model for end-stage liver disease (MELD) score (hazard ratio [HR] = 1.16, confidence interval [CI]: 1.09-1.24 and HR = 1.22, CI: 1.41-1.30) and ascites complication (HR = 2.34, CI: 1.74-3.16 and HR = 11.43, CI: 8.64-15.12). Older age (HR = 1.03, CI: 1.01-1.06), higher creatinine (HR = 6.87, CI: 1.45-32.56), and autoimmune disease versus hepatitis (HR = 2.53, CI: 1.12-5.73) were associated with increased risk of mortality after LT. Conclusion: The MELD and ascites are influential factors on waiting list mortality and occurrence of LT. Total life expectancy is not influenced by higher MELD. |
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ISSN: | 1735-1995 1735-1995 1735-7136 |
DOI: | 10.4103/jrms.jrms_1091_21 |