Skip to main content
SpringerLink
Log in

Prognostic Index of Cirrhotic Patients with Hepatic Encephalopathy with and Without Hepatocellular Carcinoma

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

This study was carried out in Japanese patients to clarify the state of liver cirrhosis complicated by hepatic encephalopathy with and without hepatocellular carcinoma and its prognosis. The subjects were 100 patients with liver cirrhosis complicated by hepatic encephalopathy. Clinical data were investigated, and prognostic factors were extracted using Cox's proportional hazard model. The cumulative survival rate after the first episode of hepatic encephalopathy was 59.1% after 1 year, 48.3% after 2 years, and 22.2% after 5 years. The prognostic index (PI) was calculated using the following formula consisting of these six factors. PI = 0.806 × Child–Pugh classification + 1.149 × presence or absence of HCC + 0.024 × BUN + 0.036 × LDH + 0.093 × WBC + 0.381 × PIVKA-II. The PI value was suggested to be useful for the prognosis of liver cirrhosis after the first episode of hepatic encephalopathy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Bustamante J, Rimola A, Ventura PJ, Navasa M, Cirera I, Reggiardo V, Rodes J: Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol 30:890–895, 1999

    Google Scholar 

  2. Abou-Assi S, Vlahcevic ZR: Hepatic encephalopathy. Metabolic consequence of cirrhosis often is reversible. Postgrad Med 109:52–65, 2001

    Google Scholar 

  3. Ikeda K, Kumada H: Long-term prognosis of liver cirrhosis. Nippon Rinsho 52:63–68, 1994 (in Japanese)

    Google Scholar 

  4. D'amico G, Morabito A, Pagliaro L, Marubini E: Survival and prognostic indicators in compensated and decompensated cirrhosis. Dig Dis Sci 31:468–475, 1986

    Google Scholar 

  5. Milani A, Marra L, Siciliano M, Rossi L: Prognostic significance of clinical and laboratory parameters in liver cirrhosis. A multivariate statistical approach. Hepatogastroenterology 32:270–272, 1985

    Google Scholar 

  6. Gentilini P, Laffi G, La Villa G, Romanelli RG, Buzzelli G, Casini-Raggi V, Melani L, Mazzanti R, Riccardi D, Pinzani M, Zignego AL: Long course and prognostic factors of virus-induced cirrhosis of the liver. Am J Gastroenterol 92:66–72, 1997

    Google Scholar 

  7. Christensen E, Krintel JJ, Hansen SM, Johansen JK, Juhl E: Prognosis after the first episode of gastrointestinal bleeding or coma in cirrhosis. Survival and prognostic factors. Scand J Gastroenterol 24:999–1006, 1989

    Google Scholar 

  8. Degos F, Christidis C, Ganne-Carrie N, Farmachidi JP, Degott C, Guettier C, Trinchet JC, Beaugrand M, Chevret S: Hepatitis C virus related cirrhosis: Time to occurrence of hepatocellular carcinoma and death. Gut 47:131–136, 2000

    Google Scholar 

  9. Schuler A, Manns MP: Patients with chronic hepatitis C-Who should not be treated? Can J Gastroenterol 14B:63B–66B, 2000

    Google Scholar 

  10. Sherlock S, Dooley J: Hepatic encephalopathy. InDiseases of the Liver and Biliary System, 6th ed. London, Blackwell Science, 1981, pp 91–106

    Google Scholar 

  11. Eggel H: Uber das primëre Carcinom der Leber. Beitre Pathol Anat 30:506–604, 1901

    Google Scholar 

  12. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R: Transection of the oesophagus for bleeding oesophageal varices.Br J Surg 60:646–649, 1973

    Google Scholar 

  13. Schlichting P, Christensen E, Andersen PK, Fauerholdt L, Juhl E, Poulsen H, Tygstrup N: Prognostic factors in cirrhosis identified by Cox's regression model. Hepatology 3:889–895, 1983

    Google Scholar 

  14. Tsuji Y, Koga S, Ibayashi H, Nose Y, Akazawa K: Prediction of the prognosis of liver cirrhosis in Japanese using Cox's proportional hazard model. Gastroenterol Jpn 22:599–606, 1987

    Google Scholar 

  15. Tarter RE, Arria AM, Van Thiel DH: Hepatic encephalopathy coexistent with alcoholism. Recent Dev Alcohol 9:205–224, 1991

    Google Scholar 

  16. Alvarez-Leal M, Contreras-Hernandez D, Chavez A, Diaz-Contreras JA, Careaga-Olivares J, Zuniga-Charles MA, Reynoso MC, Hernandez-Tellez A: Leukocyte arylsulfatase A activity in patients with alcohol-related cirrhosis. Am J Hum Biol 13:297–300, 2001

    Google Scholar 

  17. Gerber T, Schomerus H: Hepatic encephalopathy in liver cirrhosis: pathogenesis, diagnosis and management. Drugs 60:1353–1370, 2000

    Google Scholar 

  18. Nevens F, Broeckaert L, Rutgeerts P, Van Steenbergen W, Fevery J: The long-term morbidity and mortality rate in a cohort of patients with liver cirrhosis and oesophageal varices. Hepatogastroenterology 42:979–984, 1995

    Google Scholar 

  19. Capussotti L, Vergara V, Polastri R, Bouzari H, Galatola G: Liver function and encephalopathy after partial vs direct side-to-side portacaval shunt: a prospective randomized clinical trial. Surgery 127:614–621, 2000

    Google Scholar 

  20. Graudal N, Hubeck B, Bonde J, Thomsen AC: The prognostic significance of bacteremia in hepatic cirrhosis. Liver 7:138–141, 1987

    Google Scholar 

  21. Albers I, Hartmann H, Bircher J, Creutzfeldt W: Superiority of the Child-Pugh classification to quantitative liver function tests for assessing prognosis of liver cirrhosis. Scand J Gastroenterol 24:269–276, 1989

    Google Scholar 

  22. Cardenas A, Gines P, Uriz J, Bessa X, Salmeron JM, Mas A, Ortega R, Calahorra B, De Las Heras D, Bosch J, ArroyoV, Rodes J: Renal failure after upper gastrointestinal bleeding in cirrhosis: incidence, clinical course, predictive factors, and short-term prognosis.Hepatology 34:671–676, 2001

    Google Scholar 

  23. Takagi H, Uehara M, Sakurai S, Yamada S, Takayama H, Saitoh S, Ojima T, Yamada T, Abe T, Kobayashi S: Evaluation of non-surgical treatments of hepatocellular carcinoma-Investigation of the cases with long and short survivals after treatment. J Jpn Soc Cancer Ther 25:757–769, 1990 (in Japanese)

    Google Scholar 

  24. Attali P, Prod'Homme S, Pelletier G, Papoz L, Ink O, Buffet C: Etienne JP: Prognostic factors in patients with hepatocellular carcinoma.Attempts for the selection of patients with prolonged survival.Cancer 59:2108–2111, 1987

    Google Scholar 

  25. Watanabe A, Higashi T, Sakata T, Nagashima H: Serum amino acid levels in patients with hepatocellular carcinoma. Cancer 54:1875–1882, 1984

    Google Scholar 

  26. Okuda H, Nakanishi T, Takatsu K, Saito A, Hayashi N, Takasaki K, Takenami K, Yamamoto M, Nakano M: Serum levels of desgamma-carboxy prothrombin measured using the revised enzyme immunoassay kit with increased sensitivity in relation to clinicopathologic features of solitary hepatocellular carcinoma. Cancer 88:544–549, 2000

    Google Scholar 

  27. Koike Y, Shiratori Y, Sato S, Obi S, Teratani T, Imamura M, Yoshida H, Shiina S, Omata M: Des-?-carboxy prothrombin as a useful predisposing factor for the development of portal venous invasion in patients with hepatocellular carcinoma; a prospective analysis of 227 patients. Cancer 91:561–569, 2001

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Service Center, Showa University, Tokyo, Japan

    Keiichiro Yoneyama

  2. Department of Pathophysiology, Showa University School of Pharmaceutical Sciences, Tokyo, Japan

    Yuka Nebashi & Yuji Kiuchi

  3. Second Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan

    Minoru Shibata & Keiji Mitamura

Authors
  1. Keiichiro Yoneyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuka Nebashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuji Kiuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Minoru Shibata
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Keiji Mitamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yoneyama, K., Nebashi, Y., Kiuchi, Y. et al. Prognostic Index of Cirrhotic Patients with Hepatic Encephalopathy with and Without Hepatocellular Carcinoma. Dig Dis Sci 49, 1174–1180 (2004). https://doi.org/10.1023/B:DDAS.0000037808.44897.8a

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:DDAS.0000037808.44897.8a

Search

Navigation