Liver-to-abdominal area ratio for predicting the in-hospital mortality in advanced liver cirrhosis

Postgrad Med. 2017 Sep;129(7):756-761. doi: 10.1080/00325481.2017.1327781. Epub 2017 May 19.

Abstract

Objectives: To identify the value of liver-to-abdominal area ratio (LAAR) score for predicting the in-hospital mortality in advanced cirrhotic patients.

Methods: All cirrhotic patients with Child-Pugh class B or C who were admitted between July 2012 and June 2014 and underwent abdominopelvic CT scans were considered in this retrospective observational study. The association of LAAR with in-hospital death was calculated. Receiver operating characteristic curve analysis was performed. The area under curve (AUC) was calculated.

Results: In the overall analysis of 128 cirrhotic patients with Child-Pugh class B or C, LAAR score was significantly associated with the risk of in-hospital death (p = 0.012). The AUC of LAAR score for predicting the in-hospital mortality was 0.764 (p < 0.0001). The best cut-off value was 0.29 with a sensitivity of 75% and a specificity of 73.33%. In the subgroup analysis of 37 patients with Child-Pugh class C, LAAR score was significantly associated with the risk of in-hospital death (p = 0.008). The AUC of LAAR score was 0.821. The best cut-off value was 0.29 with a sensitivity of 85.71% and a specificity of 80%. In the subgroup analysis of 80 patients with moderate-severe ascites, LAAR score was not significantly associated with the risk of in-hospital death (p = 0.072). The AUC of LAAR score was 0.684 (p = 0.0158). The best cut-off value was 0.29 with a sensitivity of 75% and a specificity of 63.89%.

Conclusion: LAAR score might be effective for predicting the in-hospital death of advanced cirrhosis.

Keywords: Child-Pugh class; LAAR; Liver cirrhosis; hospital mortality; prognosis; risk.

MeSH terms

  • Abdomen / anatomy & histology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Status Indicators
  • Hospital Mortality
  • Humans
  • Liver / anatomy & histology*
  • Liver Cirrhosis / mortality*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sensitivity and Specificity
  • Severity of Illness Index