Prognostic value of free-water peritoneal clearance in decompensated cirrhosis: a 3 year prospective follow-up

Patients, 38, with decompensated cirrhosis were enrolled in a 3 year prospective follow-up to investigate the long-term prognostic value of free-water peritoneal clearance (FWPC) and intraabdominal pressure (IAP). All patients were ‘a priori’ divided into different subgroups, according to the basal values of FWPC (methylene-blue dilution method) and IAP (direct manometry). Arbitrarily chosen cut-off levels (90 ml/min for FWPC and 17 cm H₂O for IAP) were adopted. The cumulative 3 year mortality was significantly lower in the subgroup of patients with FWPC above 90 ml/min than in those with FWPC below 90 ml/min (P < 0.05, Kaplan Meier method and log-rank test). No significant difference was found between the cumulated survivals of the subgroups discriminated by means of the IAP cut-off. Our results suggest that FWPC has an intrinsic prognostic value in patients with decompensated cirrhosis. Therefore, FWPC may be helpfully considered in a multivariate prognostic model for the estimate of the individual survivals in ascitic patients.