COMMENTARY
Survival in cirrhosis
Cardiovascular determinants of survival in cirrhosis
Liver Unit, University of Calgary, Calgary, Canada
Correspondence to:
Correspondence to:
Dr S S Lee
3330 Hospital Dr NW, Calgary, AB, Canada T2N 4N1; samlee@ucalgary.ca
Diastolic response as the strongest determinant of mortality after TIPS
| The first 150 words of the full text of this article appear below. |
My heart,
Where either I must live or bear no life,
The fountain from which my current runs
Or dries up
William Shakespeare, Othello
Cirrhosis is a fatal condition. Although mild cirrhosis can be associated with prolonged survival, most diseases that induce cirrhosis progress, at variable rates, to end-stage liver failure. Deaths from hepatic failure, variceal bleeding and infection are common in advanced cirrhosis, and even the rate of sudden unexplained death is increased compared with that in a normal population.1 Moreover, patients with cirrhosis are well known to be fragile, and do poorly after invasive or stressful procedures. It is logical and intuitive to assume that the sickest patients—that is, those with the most advanced degree of liver failure—will have the poorest outcome after challenges. Indeed, this is what virtually all studies on risk factors for morbidity and mortality in cirrhosis show.2 Mortality following a variceal
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