Prognostic markers in patients with decompensated cirrhosis.

Aim: To evaluate the easily available laboratory and clinical markers in patients with decompensated cirrhosis and compare their prognostic value.

Methods: The study sample included a group of 80 patients with an established diagnosis of decompensated cirrhosis, hspitalizsed at the Department of Gastroenterohepatology, Clinical Center of the University of Sarajevo, between 2009 and 2011, followed up for 6 months either as outpatients or through repeated hspitalizsation. It was estimated that the accuracy (c-index) of the six variables, laboratory (serum bilirubin, creatinine, International Normalised Ratio (INR) and albumine) and clinical variables (hepatic encephalopathy and ascites) reflect the function of the liver in their ability to predict 6-month mortality.

Results: Laboratory values of serum creatinine equvivalent to the area under the receiver operating characteristic curve (AUC) 0.787, 95% CI 0,667-0,898), serum bilirubin (0.701 95% CI 0,582- 0,820), INR (0.647 95% CI 0,526-0,768) and clinical parameter ascites (0.7 95%CI 0,598-0,827), showed a statistically significant prognostic accuracy in predicting six-month mortality, but none of the parameters showed excellent diagnostic accuracy .

Conclusion: Serum creatinine had the best diagnostic accuracy in predicting 6-month mortality in patients with decompensated cirrhosis and as easily available variable which could be used as predictive parameter in early prognostic assessment ofliver cirrhosis.