Functional Status at Liver Transplant Waitlisting Correlates With Greater Odds of Encephalopathy, Ascites, and Spontaneous Bacterial Peritonitis
© 2020 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved..
BACKGROUND & AIMS: Whether higher liver transplant (LT) waitlist mortality in patients with poor functional status (FS) is mediated by higher prevalence of cirrhosis complications is not clear. We aim to evaluate the impact of FS on risk of hepatic encephalopathy (HE), ascites, and spontaneous bacterial peritonitis (SBP) among adults listed for LT.
METHODS: Using 2005-2018 United Network for Organ Sharing LT data, we retrospectively evaluated the impact of FS on prevalence of ascites, HE, and SBP among adults listed for LT using Karnofsky Performance Status Score categories (KPSS-1: FS 80-100%, KPSS-2: 60-70%, KPSS-3: 40-50%, KPSS-4: 10-30%), stratified by underlying liver disease etiology. Between-group comparisons used chi-squared methods and adjusted multivariate logistic regression.
RESULTS: Among 100,618 adults listed for LT (68.8% male, 72.4% non-Hispanic white) 35.2% were KPSS-1, 36.6% KPSS-2, 15.7% KPSS-3, and 12.6% KPSS-4 at time of LT waitlist registration. Patients with worse FS were significantly more likely to have ascites, HE, and SBP at time of waitlist registration (KPSS-1 vs. KPSS-4: ascites, 66% vs. 93%; HE, 81% vs. 49%; SBP, 4% vs. 16%, p < 0.001 for all). On multivariate regression, compared with patients with KPSS-1, those with KPSS-4 had significantly higher odds of ascites (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.37-1.62, p < 0.01), HE (OR: 1.69, 95% CI: 1.59-1.80, p < 0.01), and SBP (OR: 2.17, 95% CI: 1.98-2.38, p < 0.01), which was observed across all liver disease etiologies.
CONCLUSION: Worse FS is associated with higher odds of cirrhosis complications including ascites, HE, and SBP, which was observed across all liver disease etiologies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Journal of clinical and experimental hepatology - 10(2020), 5 vom: 20. Sept., Seite 413-420 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
McCabe, Patrick [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 17.04.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.jceh.2020.04.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31599150X |
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| 100 | 1 | |a McCabe, Patrick |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Functional Status at Liver Transplant Waitlisting Correlates With Greater Odds of Encephalopathy, Ascites, and Spontaneous Bacterial Peritonitis |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Revised 17.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2020 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND & AIMS: Whether higher liver transplant (LT) waitlist mortality in patients with poor functional status (FS) is mediated by higher prevalence of cirrhosis complications is not clear. We aim to evaluate the impact of FS on risk of hepatic encephalopathy (HE), ascites, and spontaneous bacterial peritonitis (SBP) among adults listed for LT | ||
| 520 | |a METHODS: Using 2005-2018 United Network for Organ Sharing LT data, we retrospectively evaluated the impact of FS on prevalence of ascites, HE, and SBP among adults listed for LT using Karnofsky Performance Status Score categories (KPSS-1: FS 80-100%, KPSS-2: 60-70%, KPSS-3: 40-50%, KPSS-4: 10-30%), stratified by underlying liver disease etiology. Between-group comparisons used chi-squared methods and adjusted multivariate logistic regression | ||
| 520 | |a RESULTS: Among 100,618 adults listed for LT (68.8% male, 72.4% non-Hispanic white) 35.2% were KPSS-1, 36.6% KPSS-2, 15.7% KPSS-3, and 12.6% KPSS-4 at time of LT waitlist registration. Patients with worse FS were significantly more likely to have ascites, HE, and SBP at time of waitlist registration (KPSS-1 vs. KPSS-4: ascites, 66% vs. 93%; HE, 81% vs. 49%; SBP, 4% vs. 16%, p < 0.001 for all). On multivariate regression, compared with patients with KPSS-1, those with KPSS-4 had significantly higher odds of ascites (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.37-1.62, p < 0.01), HE (OR: 1.69, 95% CI: 1.59-1.80, p < 0.01), and SBP (OR: 2.17, 95% CI: 1.98-2.38, p < 0.01), which was observed across all liver disease etiologies | ||
| 520 | |a CONCLUSION: Worse FS is associated with higher odds of cirrhosis complications including ascites, HE, and SBP, which was observed across all liver disease etiologies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a AC, alcoholic cirrhosis | |
| 650 | 4 | |a ECOG, Eastern Cooperative Oncology Group | |
| 650 | 4 | |a FS, functional status | |
| 650 | 4 | |a HCC, hepatocellular carcinoma | |
| 650 | 4 | |a HCV, hepatitis C virus | |
| 650 | 4 | |a HE, hepatic encephalopathy | |
| 650 | 4 | |a KPSS, Karnofsky performance status score | |
| 650 | 4 | |a LT, liver transplant | |
| 650 | 4 | |a MELD, Model for End-Stage Liver Disease | |
| 650 | 4 | |a NASH, non,alcoholic steatohepatitis | |
| 650 | 4 | |a OPTN, Organ Procurement Transplant Network | |
| 650 | 4 | |a SBP, spontaneous bacterial peritonitis | |
| 650 | 4 | |a UNOS | |
| 650 | 4 | |a UNOS, United Network for Organ Sharing | |
| 650 | 4 | |a cirrhosis | |
| 650 | 4 | |a decompensation | |
| 650 | 4 | |a functional status | |
| 650 | 4 | |a karnofsky | |
| 700 | 1 | |a Hirode, Grishma |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Robert |e verfasserin |4 aut | |
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