Model of La Mura et al for Predicting Outcome in a Patient with Cirrhosis and Portal Hypertension Using von Willebrand Factor Concentration and MELD Score
La Mura et al correlated plasma levels of von Willebrand factor (vWF) with prognosis for patients with cirrhosis and portal hypertension. Plasma vWF concentrations and the MELD score can identify a patient who may benefit from more aggressive management. The authors are from the University of Barcelona in Spain.
Patient selection: cirrhosis with portal hypertension (hepatic venous pressure gradient or HVPG >= 12 mm Hg)
Outcomes:
(1) portal hypertension-related event (PHRE): variceal bleeding, de novo ascites or ascites requiring hospitalization, hepatic encephalopathy requiring hospitalization, hepatorenal syndrome, spontaneous bacterial peritonitis
(2) liver transplantation
(3) death
Parameters:
(1) plasma von Willebrand factor antigen concentration in U/dL (mean 104 U/dL with standard devation 13)
(2) MELD score
MELD Score
vWF antigen concentration
Percent Free of PHRE and Transplantation
<= 10
< 216 U/dL
100%
<= 10
>= 216 U/dL
26%
> 10
< 216 U/dL
67%
> 10
>= 216 U/dL
19%
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