1. Relationship Between 13C-Aminopyrine Breath Test and the MELD Score and Its Long-Term Prognostic Use in Patients with Cirrhosis
- Author
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Vincenzo Savarino and Edoardo G. Giannini
- Subjects
Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,Physiology ,Kaplan-Meier Estimate ,Gastroenterology ,Cohort Studies ,End Stage Liver Disease ,Liver disease ,Transplant surgery ,Liver Function Tests ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,In patient ,Prospective Studies ,Aminopyrine ,Breath test ,Carbon Isotopes ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Hepatology ,Prognosis ,medicine.disease ,Liver Transplantation ,Survival Rate ,Breath Tests ,ROC Curve ,Female ,Liver function ,Liver function tests ,business ,Follow-Up Studies - Abstract
(13)C-Aminopyrine breath test ((13)C-ABT) is a non-invasive, dynamic, quantitative liver function test, and the model for end-stage liver disease (MELD) is a recognised biochemical score used to predict survival in patients with cirrhosis.The purpose of this study was to evaluate the relationship between the (13)C-ABT and MELD score in a cohort of cirrhotic patients and, moreover, to assess the prognostic value of (13)C-ABT results in the same group of patients.Forty-six patients with cirrhosis and without hepatocellular carcinoma who underwent (13)C-ABT and who had at least 1-year follow-up were prospectively included in this study. MELD score was calculated at entry into the study in all patients. End-points of the study were 1-year liver-related death or liver transplantation.(13)C-ABT %dose/h at 30 min (%dose/h30) results showed significant, inverse correlation with MELD scores (r = -0.414, P = 0.004). During 1-year follow-up nine patients died (19.6 %) and two were transplanted (4.3 %). Median (13)C-ABT %dose/h30 results (3.2 vs. 1.8) were significantly higher in patients who survived as compared to those who died or underwent transplantation (P = 0.04). Receiver operating characteristics curves showed that a (13)C-ABT %dose/h30 cut-off of 2.0 had the best accuracy (c-index = 0.717) in assessing 1-year prognosis.We observed a correlation between a flow-independent quantitative liver function test and the MELD score, and found that the (13)C-ABT may accurately provide long-term prognostic information in cirrhotic patients.
- Published
- 2013