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http://hdl.handle.net/2445/47248
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DC Field | Value | Language |
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dc.contributor.author | Qamar, A. A. | - |
dc.contributor.author | Grace, N. D. | - |
dc.contributor.author | Groszmann, Roberto J. | - |
dc.contributor.author | Garcia Tsao, Guadalupe | - |
dc.contributor.author | Bosch i Genover, Jaume | - |
dc.contributor.author | Burroughs, Andrew K. | - |
dc.contributor.author | Ripoll, Cristina | - |
dc.contributor.author | Maurer, R. | - |
dc.contributor.author | Planas, R. | - |
dc.contributor.author | Escorsell i Mañosa, M. Àngels | - |
dc.contributor.author | García Pagán, Juan Carlos | - |
dc.contributor.author | Patch, D. | - |
dc.contributor.author | Matloff, D. S. | - |
dc.contributor.author | Makuch, R. | - |
dc.contributor.author | Rendon, G. | - |
dc.date.accessioned | 2013-10-24T08:30:58Z | - |
dc.date.available | 2013-10-24T08:30:58Z | - |
dc.date.issued | 2009-03-12 | - |
dc.identifier.issn | 1542-3565 | - |
dc.identifier.uri | http://hdl.handle.net/2445/47248 | - |
dc.description.abstract | 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. | - |
dc.format.extent | 7 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Elsevier | - |
dc.relation.isformatof | Versió postprint del document publicat a: http://dx.doi.org/10.1016/j.cgh.2009.02.021 | - |
dc.relation.ispartof | Clinical Gastroenterology and Hepatology, 2009, vol. 7, num. 6, p. 689-695 | - |
dc.relation.uri | http://dx.doi.org/10.1016/j.cgh.2009.02.021 | - |
dc.rights | (c) AGA Institute, 2009 | - |
dc.source | Articles publicats en revistes (Medicina) | - |
dc.subject.classification | Cirrosi hepàtica | - |
dc.subject.classification | Hematologia | - |
dc.subject.classification | Assaigs clínics | - |
dc.subject.classification | Malalties del fetge | - |
dc.subject.other | Hepatic cirrhosis | - |
dc.subject.other | Hematology | - |
dc.subject.other | Clinical trials | - |
dc.subject.other | Liver diseases | - |
dc.title | Incidence, prevalence and clinical significance of abnormal hematological indices in compensated cirrhosis | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/acceptedVersion | - |
dc.identifier.idgrec | 581094 | - |
dc.date.updated | 2013-10-24T08:31:18Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 19281860 | - |
Appears in Collections: | Articles publicats en revistes (Medicina) |
Files in This Item:
File | Description | Size | Format | |
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581094.pdf | 1.03 MB | Adobe PDF | View/Open |
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