Elsevier

Journal of Hepatology

Volume 44, Issue 1, January 2006, Pages 217-231
Journal of Hepatology

Review
Natural history and prognostic indicators of survival in cirrhosis: A systematic review of 118 studies

https://doi.org/10.1016/j.jhep.2005.10.013Get rights and content

Section snippets

Background

Liver transplantation significantly improves the survival and quality of life of patients with end-stage cirrhosis. However, a large proportion of cirrhotic patients still die while on the transplant list because of an insufficient number of donors and because of the lack of an accurate prediction of life expectancy. Although many prognostic models have been proposed in the last two decades to predict mortality in cirrhosis, the Child–Pugh score [1] is by far the most largely used both in

Natural history of cirrhosis

Cirrhosis is the end-stage of every chronic liver disease. Its natural history is characterized by an asymptomatic phase, termed ‘compensated’ cirrhosis followed by a rapidly progressive phase marked by the development of complications of portal hypertension and/or liver dysfunction, termed ‘decompensated cirrhosis’ (Fig. 1). In the compensated phase, portal pressure may be normal or below the threshold level identified for the development of varices or ascites (‘clinically significant portal

Discussion

Prognosis is an essential part of the baseline assessment of any disease. It is not only the basis for the information that a physician provides to the patient, but is also the basis for any decision-making process. However, the applicability of the available prognostic information to the individual patient is frequently unsatisfactory because individual patients are different from the average patient population on which a prognostic estimation is based. Apart from the individual biologic

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