1. Higher free serum cortisol is associated with worse survival in acute variceal bleeding because of cirrhosis
- Author
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Konstantinos Zisimopoulos, Eleni Jelastopulu, Georgios Theocharis, Elias A. Kouroumalis, Christos Triantos, Apostolos Sapountzis, Konstantinos Thomopoulos, Dimitrios Samonakis, Maria Kalafateli, Nikolaos Papiamonis, Andrew K. Burroughs, Chryssoula Labropoulou-Karatza, Vasiliki Nikolopoulou, Venetsanea Kyriazopoulou, and Marina Michalaki
- Subjects
Liver Cirrhosis ,Male ,Time Factors ,Cirrhosis ,Hydrocortisone ,Severity of Illness Index ,Gastroenterology ,Liver Function Tests ,Risk Factors ,London ,Prospective Studies ,Prospective cohort study ,Aged, 80 and over ,Greece ,biology ,Liver Neoplasms ,Area under the curve ,Middle Aged ,Prognosis ,Up-Regulation ,Area Under Curve ,Hepatocellular carcinoma ,Acute Disease ,Corticosteroid ,Female ,Gastrointestinal Hemorrhage ,Adult ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Globulin ,medicine.drug_class ,Serum Albumin, Human ,Esophageal and Gastric Varices ,Predictive Value of Tests ,Internal medicine ,Severity of illness ,medicine ,Adrenal insufficiency ,Humans ,Serum Albumin ,Aged ,Proportional Hazards Models ,Chi-Square Distribution ,Hepatology ,business.industry ,medicine.disease ,Surgery ,Logistic Models ,ROC Curve ,Multivariate Analysis ,Adrenal Cortex ,biology.protein ,Carrier Proteins ,business ,Biomarkers - Abstract
BACKGROUND AND AIMS Critical illness-related corticosteroid insufficiency has been reported in acute variceal bleeding (AVB). In cirrhosis, free serum cortisol (FC) is considered optimal to assess adrenal function. Salivary cortisol (SC) is considered a surrogate for FC. We evaluated FC and its prognostic role in AVB. METHODS Total serum cortisol, SC, cortisol-binding globulin, and FC (Coolens' formula) were evaluated in AVB (n=38) and in stable cirrhosis (CC) (n=31). A Cox proportional hazards model was evaluated for 6-week survival. RESULTS In AVB, the median FC and SC levels were higher with worse liver dysfunction [Child-Pugh (CP) A/B/C: 1.59/2.62/3.26 μg/dl, P=0.019; CPA/B/C: 0.48/0.897/1.81 μg/ml, P
- Published
- 2014