Curakova Ristovska Elena, Genadieva-Dimitrova Magdalena
Intensive Care Unit, University Clinic for Gastroenterohepatology, Skopje 1000, North Macedonia.
Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje 1000, North Macedonia.
World J Hepatol. 2022 Apr 27;14(4):812-826. doi: 10.4254/wjh.v14.i4.812.
Von-Willebrand factor (vWF) disposes certain prognostic value in patients with liver cirrhosis, but its relation to other prognostic indicators has not been fully investigated.
To analyze the relation between vWF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality.
This analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension. It analyzed the relation between vWF and the stage of the disease and several inflammatory and prognostic indicators. The prospective analysis, performed on a sample of 63 patients, evaluated the association between the selected variables [vWF, Model for End-stage Liver Disease (MELD) score, C-reactive protein (CRP), ferritin, vitamin D, activated partial thromboplastin time, thrombin time, D-dimer concentration] and the survival time as well as their predictive value in terms of 3-mo, 6-mo and 1-year mortality.
vWF was significantly higher in patients with higher Child-Turcotte-Pugh class ( = 0.0045), MELD group ( = 0.0057), ferritin group ( = 0.0278), and D-dimer concentration ( = 0.0232). vWF significantly correlated with D-dimer concentration, ferritin, CRP, International Normalized Ratio, and MELD, Child-Turcotte-Pugh, Sequential Organ Failure Assessment, and CLIF-consortium organ failure (CLIF-C OF) scores. vWF, MELD score, and CRP were significantly associated with death and were significant predictors of 3-mo, 6-mo, and 1-year mortality. Each vWF unit significantly increased the probability for 3-mo mortality by 1.005 times ( = 0.008), for 6-mo mortality by 1.006 times ( = 0.005), and for 1-year mortality by 1.007 times ( = 0.002). There was no significant difference between the diagnostic performance of vWF and MELD score and also between vWF and CRP regarding the 3-mo, 6-mo, and 1-year mortality.
In patients with liver cirrhosis, vWF is significantly related to other prognostic indicators and is a significant predictor of 3-mo, 6-mo, and 1-year mortality similar to MELD score and CRP.
血管性血友病因子（vWF）在肝硬化患者中具有一定的预后价值，但其与其他预后指标的关系尚未得到充分研究。
分析肝硬化患者中vWF与其他预后指标的关系，并评估其对死亡率的预后价值。
这项分析性前瞻性研究在一家三级中心进行，最初纳入71例肝硬化和门静脉高压患者。分析了vWF与疾病分期以及几种炎症和预后指标之间的关系。对63例患者的样本进行前瞻性分析，评估所选变量[vWF、终末期肝病模型（MELD）评分、C反应蛋白（CRP）、铁蛋白、维生素D、活化部分凝血活酶时间、凝血酶时间、D-二聚体浓度]与生存时间的关联以及它们在3个月、6个月和1年死亡率方面的预测价值。
在Child-Turcotte-Pugh分级较高（P = 0.0045）、MELD分组较高（P = 0.0057）、铁蛋白分组较高（P = 0.0278）和D-二聚体浓度较高（P = 0.0232）的患者中，vWF显著更高。vWF与D-二聚体浓度、铁蛋白、CRP、国际标准化比值以及MELD、Child-Turcotte-Pugh、序贯器官衰竭评估和CLIF联盟器官衰竭（CLIF-C OF）评分显著相关。vWF、MELD评分和CRP与死亡显著相关，并且是3个月、6个月和1年死亡率的显著预测指标。vWF每升高一个单位，3个月死亡率的概率显著增加1.005倍（P = 0.008），6个月死亡率增加1.006倍（P = 0.005），1年死亡率增加1.007倍（P = 0.002）。在3个月、6个月和1年死亡率方面，vWF与MELD评分以及vWF与CRP的诊断性能之间没有显著差异。
在肝硬化患者中，vWF与其他预后指标显著相关，并且与MELD评分和CRP一样，是3个月、6个月和1年死亡率的显著预测指标。
