Key result
A candidate risk model incorporating HDL, PTA, PVW, D-dimer, IgG, and MELD score strongly predicted the occurrence of hepatic hydrothorax in patients with cirrhosis (AUC 0.805).
Why the study?
Hepatic hydrothorax is an important complication of end-stage cirrhosis linked to prognosis and mortality, but its risk factors needed detection to better understand this potentially life-threatening complication.
What are the clinical and laboratory risk factors for hepatic hydrothorax in patients with cirrhosis?
Case-Control (n=978)
No
What are the clinical and laboratory risk factors for hepatic hydrothorax in patients with cirrhosis?
Effect estimate: AUC 0.805 (95% CI 0.758-0.851)
p-value: p=<0.001
Lower HDL and prothrombin activity, along with higher portal vein width, D-dimer, IgG, and MELD scores, are significant risk factors for hepatic hydrothorax in cirrhotic patients.
These factors were associated with hepatic hydrothorax; leaves open whether they improve risk stratification or warrant targeted trials.
Aims and background Hepatic hydrothorax, which presents as an unexplained pleural effusion, is one of the important complications in patients with end-stage cirrhosis. It has a significant correlation with prognosis and mortality. The aim of this clinical study was to detect the risk factors for hepatic hydrothorax in patients with cirrhosis and to better understand potentially life-threatening complications. Methods Retrospectively, 978 cirrhotic patients who were hospitalized at the Shandong Public Health Clinical Center from 2013 to 2021 were involved in this study. They were divided into the observation group and the control group based on the presence of hepatic hydrothorax. The epidemiological, clinical, laboratory, and radiological characteristics of the patients were collected and analyzed. ROC curves were used to evaluate the forecasting ability of the candidate model. Furthermore, 487 cases in the experimental group were divided into left, right, and bilateral groups, and the data were analyzed. Results The patients in the observation group had a higher proportion of upper gastrointestinal bleeding (UGIB), a history of spleen surgery, and a higher model for end-stage liver disease (MELD) scores compared with the control group. The width of the portal vein (PVW) (P = 0.022), prothrombin activity (PTA) (P = 0.012), D-dimer (P = 0.010), immunoglobulin G (IgG) (P = 0.007), high-density lipoprotein cholesterol (HDL) (P = 0.022), and the MELD score were significantly associated with the occurrence of the hepatic hydrothorax. The AUC of the candidate model was 0.805 (P < 0.001, 95% CI = 0.758–0.851). Portal vein thrombosis was more common in bilateral pleural effusion compared with the left and right sides (P = 0.018). Conclusion The occurrence of hepatic hydrothorax has a close relationship with lower HDL, PTA, and higher PVW, D-dimer, IgG, and MELD scores. Portal vein thrombosis is more common in cirrhotic patients with bilateral pleural effusion compared to those with unilateral pleural effusion.
No takes yet. Share an insight, caveat, or question.
Bai et al. (2023) conducted a case-control in Cirrhosis (n=978). Risk factors for hepatic hydrothorax (including MELD score, PVW, D-dimer, IgG, PTA, HDL) vs. Patients without hepatic hydrothorax was evaluated on Predictive ability of the candidate risk model for hepatic hydrothorax (AUC 0.805, 95% CI 0.758-0.851, p=<0.001). A candidate risk model incorporating HDL, PTA, PVW, D-dimer, IgG, and MELD score strongly predicted the occurrence of hepatic hydrothorax in patients with cirrhosis (AUC 0.805).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: