Dergiler / Marmara Medical Journal / 2016 / Cilt: 29 - Sayı: 2
The value of non-invasive tests for risk stratification in patients with compensated cirrhosis
- Sayfa
- 55–58
- DOI
- —
Özet
Liver cirrhosis is characterized by a long compensatedphase, with a median survival from diagnosis of around12 years. When decompensation occurs (variceal bleeding,jaundice, hepatic encephalopathy or ascites) the expectedmedian survival is around two years [1,2]. Whereas there area number of well-validated scores for prognosis predictionand risk stratification in patients with decompensatedcirrhosis, these are very limited in the case of compensatedcirrhosis [1]. The two most widely validated prognosticfactors in compensated cirrhosis are the presence of clinicallysignificant portal hypertension (CSPH) [3], defined asa hepatic venous pressure gradient ≥10 mmHg, and thepresence of esophageal varices [1]. The gold standard teststo assess CSPH and varices are hepatic vein catheterismand endoscopy, respectively [4]. However, these tests,especially hepatic vein catheterism, are relatively invasiveand impractical for the frequent follow-up of these patients.This has fostered the interest in the use of non-invasive toolsfor the assessment of patients with compensated cirrhosis.
Abstract
Liver cirrhosis is characterized by a long compensatedphase, with a median survival from diagnosis of around12 years. When decompensation occurs (variceal bleeding,jaundice, hepatic encephalopathy or ascites) the expectedmedian survival is around two years [1,2]. Whereas there area number of well-validated scores for prognosis predictionand risk stratification in patients with decompensatedcirrhosis, these are very limited in the case of compensatedcirrhosis [1]. The two most widely validated prognosticfactors in compensated cirrhosis are the presence of clinicallysignificant portal hypertension (CSPH) [3], defined asa hepatic venous pressure gradient ≥10 mmHg, and thepresence of esophageal varices [1]. The gold standard teststo assess CSPH and varices are hepatic vein catheterismand endoscopy, respectively [4]. However, these tests,especially hepatic vein catheterism, are relatively invasiveand impractical for the frequent follow-up of these patients.This has fostered the interest in the use of non-invasive toolsfor the assessment of patients with compensated cirrhosis.