9%). Hepatitis C was the cause of cirrhosis in 40.8% of the patients, alcohol abuse in
17.5% selleck chemicals and hepatitis B in 3.9%. The mean MELD score was 15.7 ± 6.1 and 36.9% of the individuals were Child-Pugh C. IGF-1 levels positively correlated with albumin levels and negatively correlated with INR, CPR, total bilirubin and MELD. Significantly lower IGF-1 levels were observed in Child-Pugh C patients (P = 0.007) but not in subjects with ACLF (P = 0.222). The 90-day mortality was 26.2% and it was associated in the bivariate analysis with older age, bacterial infection, presence of ascites, hepatic encephalop-athy, Child-Pugh C and ACLF at admission. Concerning laboratory data, 90-day mortality was associated with higher creatinine, INR, CRP, venous lactate, total bilirubin, MELD and lower sodium, albumin and IFG-1 at admission. Stepwise forward logistic regression analysis including variables with P < 0.01 in the bivariate analysis showed that MELD score (OR 1.20, 95% CI 1.08-1.34, P = 0.001), ascites at admission (OR 12.37, 95% CI 2.73-55.96, P = 0.001) and IGF-1 levels (OR 0.91, 95% CI 0.84-0.99, P = 0.031) were independently associated with 90-day mortality. The Kaplan-Meier survival probability (figure) at 90-day was 87.8% in patients with IGF-1 > 10 ng/mL and 61.1% for subjects www.selleckchem.com/products/cb-839.html with IGF-1 < 10 ng/mL (P
= 0.003). Significantly lower IGF-1 levels were found at the time of acute decompensation
of cirrhosis as compared to the outpatient evaluation (21.9 ± 23.3 ng/mL vs. 49.3 ± 33.3 ng/mL, P < 0.001). Conclusion: IGF-1 levels decrease during acute decompensation of cirrhosis and were independently associated with short-term prognosis. Disclosures: The following people have nothing to disclose: Bruno S. Colombo, Marcelo F. Ronsoni, Pedro E. Soares selleck screening library e Silva, Leonardo Fayad, Leticia M. Wildner, Maria Luiza Bazzo, Esther B. Dantas-Correa, Janaina L. Narciso-Schiavon, Leonardo L. Schiavon Patients with end-stage liver disease candidates for liver transplantation are sorted according to MELD score. The Systemic Inflammatory Response Syndrome impacts on the prognosis of these patients but is not taken into account by the MELD. In a recent study CRP a marker of systemic inflammation, has been reported to predict 6-month mortality in hospitalized cirrhotic patients with Child-Pugh score>B7. This study demonstrated the good prognostic value of a 3-variables model incorporating MELD score, extrahepatic comorbidities, and variation of CRP levels within 15 days. Objectives: 1) to provide an external validation of the pejorative influence of sustained high CRP levels in cirrhotic patients;2) to optimize the prognostic model without considering extrahepatic comorbidities to make it more appropriate to the context of liver transplantation, 3) to test the model for predicting 3 month mortality.