Abstract
Background and aimsHepatitis B virus-related decompensated cirrhosis is difficult to cure but has a high readmission rate due to multiple complications. Our aim was to investigate the diagnostic potential value of plasma diamine oxidase (DAO) for 6-month readmission of patients with HBV-related decompensated cirrhosis.MethodsA total of 135 patients with HBV-related decompensated cirrhosis were prospectively collected at the onset of discharge of hospital, and then were followed up for at least 6 months with the readmission as the primary outcome. The plasma DAO level was measured using enzyme linked immunosorbent assay. In addition, 120 age and sex matched patients with HBV-related compensated cirrhosis were included as controls.ResultsA total of 36 patients (36.7%) with decompensated cirrhosis admitted to hospital during the 6-month follow up. The plasma DAO level of readmission group [21.1 (14.5; 29.0) ng/ml] was significantly higher than that in the non-readmission group [12.7 (9.3; 18.0) ng/mL, P < 0.001]. Multivariate analysis showed that the plasma DAO level (HR = 1.102, P < 0.05) and hepatic encephalopathy (HE) (HR = 5.018, P < 0.05) were independent factors for 6-month readmission of decompensated cirrhosis. DAO level showed higher area under the curve of receiver operating characteristic (AUROC) than HE (0.769 vs. 0.598, P < 0.05) and Child-Pugh-Turcotte (CPT) score (0.769 vs. 0.652, P < 0.05) for predicting 6-month readmission rate, with the best cut-off value as 19.7 ng/mL. Furthermore, plasma DAO level (HR = 1.184, P < 0.05) was an independent factor and has the higher AUROC than CPT score for the onset of recurrent HE (0.905 vs. 0.738, P < 0.05) during the 6-month follow up.ConclusionsPlasma DAO level > 19.7 ng/mL predicts high rate of 6-month readmission in patients with HBV-related decompensated cirrhosis.
Highlights
Liver cirrhosis is a chronic, progressive, diffuse fibrosis of the liver which is mainly caused by hepatitis B virus (HBV) infection in China [1, 2]
70 age and sex matched Chronic Hepatitis B (CHB) patients, 120 HBV-related compensated cirrhosis patients, 40 hepatocellular carcinoma (HCC) patients and 12 healthy controls were included as controls
HBV-related decompensated cirrhosis is often accompanied by gastrointestinal bleeding, hepatic encephalopathy, spontaneous peritonitis and other complications, resulting in repeated hospitalization [27]
Summary
Liver cirrhosis is a chronic, progressive, diffuse fibrosis of the liver which is mainly caused by hepatitis B virus (HBV) infection in China [1, 2]. 3% ~ 5% of liver cirrhosis will develop to the decompensated state from compensated state, and the 5-year survival rate of decompensated cirrhosis is only about 14% ~ 35% [3]. It is very important to assess the liver function of liver cirrhosis patients in detail and clarify the factors of readmission. Hepatitis B virus-related decompensated cirrhosis is difficult to cure but has a high readmission rate due to multiple complications. Our aim was to investigate the diagnostic potential value of plasma diamine oxidase (DAO) for 6-month readmission of patients with HBV-related decompensated cirrhosis
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