To access the full text documents, please follow this link: http://hdl.handle.net/2445/47248

Incidence, prevalence and clinical significance of abnormal hematological indices in compensated cirrhosis.
Qamar, A.A.; Grace, N.D.; Groszmann, R.J.; Garcia Tsao, G.; Bosch i Genover, Jaume; Burroughs, A.K.; Ripoll, C.; Maurer, R.; Planas, R.; Escorsell, A.; García Pagán, Juan Carlos; Patch, D.; Matloff, D.S.; Makuch, R.; Rendon, G
Universitat de Barcelona
Background & Aims: Patients with cirrhosis develop abnormal hematologic indices (HI) from multiple factors, including hypersplenism. We aimed to analyze the sequence of events and determine whether abnormal HI has prog-nostic significance. Methods: We analyzed a database of 213 subjects with compensated cirrhosis without esopha-geal varices. Subjects were followed for approximately 9 years until the development of varices or variceal bleeding or completion of the study; 84 subjects developed varices. Abnormal HI was defined as anemia at baseline (hemoglo-bin,<13.5 g/dL for men and 11.5 g/dL for women), leuko-penia (white blood cell counts,<4000/mm 3 ), or thrombo-cytopenia (platelet counts, < 150,000/mm 3 ). The primary end points were death or transplant surgery. Results: Most subjects had thrombocytopenia at baseline. Kaplan-Meier analysis showed that leukopenia occurred by 30 months (95% confidence interval, 18.5-53.6), and anemia occurred by 39.6 months (95% confidence interval, 24.1-49.9). Baseline thrombocytopenia (P .0191) and leukope-nia (P.0383) were predictors of death or transplant, after adjusting for baseline hepatic venous pressure gradient (HVPG), and Child-Pugh scores. After a median of 5 years,a significant difference in death or transplant, mortality,and clinical decompensation was observed in patients who had leukopenia combined with thrombocytopenia at base- line compared with patients with normal HI (P < .0001). HVPG correlated with hemoglobin and white blood cell count (hemoglobin, r 0.35, P < .0001; white blood cell count, r 0.31, P < .0001). Conclusions: Thrombocy-topenia is the most common and first abnormal HI to occurin patients with cirrhosis, followed by leukopenia and anemia. A combination of leukopenia and thrombocytopenia at baselin predicted increased morbidity and mortality.
Cirrosi hepàtica
Hematologia
Assaigs clínics
Malalties del fetge
Hepatic cirrhosis
Hematology
Clinical trials
Liver diseases
(c) AGA Institute, 2009
Article
info:eu-repo/semantics/acceptedVersion
Elsevier
         

Show full item record

Related documents

Other documents of the same author

Burroughs, Andrew K.; Groszmann, Roberto J.; Bosch i Genover, Jaume; Grace, N.; Garcia-Tsao, G.; Patch, D.; García Pagán, Juan Carlos; Dagher, L.
Fernández Bañares, Fernando; Esteve i Comas, Maria; Navarro, E.; Cabré i Gelada, Eduard; Bosch i Genover, Jaume; Abad, Águeda; Klaassen, J.; Planas, R.; Humbert Yagüe, Pere; Pastor, C.; Gassull, Miquel Àngel
Berzigotti, A.; De Gottardi, A.; Vukotic, R.; Siramolpiwat, S.; Abraldes, J.G.; García Pagán, Juan Carlos; Bosch i Genover, Jaume
Laviña Siemsen, Bàrbara; Gracia-Sancho, Jorge; Rodríguez-Vilarrupla, A.; Chu, Y.; Heistad, D. D.; Bosch i Genover, Jaume; García Pagán, Juan Carlos
Angermayr, Bernhard; Fernández Lobato, Mercedes; Mejías, Marc; Gracia-Sancho, Jorge; García Pagán, Juan Carlos; Bosch i Genover, Jaume
 

Coordination

 

Supporters