Abnormal glucose tolerance: a predictor of 30-day mortality in patients with decompensated liver cirrhosis.

摘要

BACKGROUND: In liver cirrhosis an abnormal glucose tolerance correlates with a poor long-term prognosis. The aim of this study was to evaluate whether a disturbed glucose metabolism predicts the short-term prognosis in hospitalized patients with decompensated liver cirrhosis. METHODS: Seventy-eight patients with liver cirrhosis were prospectively enrolled. Disturbed glucose metabolism was determined by a 75-g oral glucose tolerance test (OGTT) according to WHO criteria. Differences in survival were assessed by chi (2) test for 30-day mortality and by multivariate Cox proportional hazards analysis for long-term survival. RESULTS: Impaired glucose tolerance (IGT) was diagnosed in 29 patients (37 %) and diabetes mellitus (DM) in 26 patients (33 %). A pathological OGTT result was a significant negative predictor of a poor 30-day survival compared to NGT (OR 8.6; p=0.03). DM but not IGT was an independent negative predictor of long-term survival (HR=1.89; p=0.04). CONCLUSION: Disturbed glucose metabolism in hospitalized patients with decompensated liver cirrhosis is correlated with increased 30-day mortality. OGTT appears to be useful for identifying cirrhotic patients with poor short term prognosis.