Predictive models and clinical manifestations of intrapulmonary vascular dilatation and hepatopulmonary syndrome in patients with cirrhosis: Prospective comparative study

Table 1 Baseline characteristics and clinical data after hospitalization of patients with cirrhosis with and without intrapulmonary vascular dilatation, n (%)

Variables	Total (n = 320)	Without IPVD (n = 219)	With IPVD (n = 101)	P value
Demographic data
Sex, male	246 (77)	178 (81)	68 (67)	0.006
Age, years	58 (52-65)	59 (53-66)	56.00 (49-62)	0.001
Weight, kg	69 (60-77)	70 (61-77)	65 (56-77)	0.024
Height, m	1.70 (1.64-1.74)	1.70 (1.65-1.75)	1.68 (1.60-1.73)	0.052
BMI, kg/m2	24.03 (21.58-26.64)	24.47 (22.11-26.91)	23.24 (20.76-26.20)	0.046
Smoke	129 (40)	90 (41)	39 (39)	0.65
Drink	125 (39)	86 (39)	39 (39)	0.89
Cause1
Alcoholic liver disease	65 (20)	43 (20)	22 (22)	0.66
Hepatitis B	189 (59)	142 (65)	47 (47)	0.002
Hepatitis C	44 (14)	31 (14)	13 (13)	0.76
NAFLD	5 (1.6)	3 (1.4)	2 (2.0)	0.65
Autoimmune hepatitis	26 (8.1)	12 (5.5)	14 (14)	0.011
Other	17 (5.3)	8 (3.7)	9 (8.9)	0.051
Co-morbidities
Hypertension	93 (29)	77 (35)	16 (16)	< 0.001
Diabetes	91 (28)	73 (33)	18 (18)	0.004
Heart failure	25 (7.8)	18 (8.2)	7 (6.9)	0.69
Kidney failure	60 (19)	41 (19)	19 (19)	0.98
Liver cancer	193 (60)	143 (65)	50 (50)	0.007
Esophageal varices	201 (63)	137 (63)	64 (63)	0.97
Bleeding	89 (28)	59 (27)	30 (30)	0.61
Ascites	207 (65)	130 (59)	77 (76)	0.003
Hepatic encephalopathy	94 (29)	56 (26)	38 (38)	0.028
Clubbing of the fingers	3 (0.9)	2 (0.9)	1 (1.0)	0.99
Palmar erythema	61 (19)	35 (16)	26 (26)	0.039
Spider angioma	8 (2.5)	3 (1.4)	5 (5.0)	0.11
Disease severity
MELD score	11.1 (5.9-17.8)	8.9 (5.5-14.3)	15.4 (10.0-25.8)	< 0.001
Child-Pugh classification				< 0.001
I	113 (35)	99 (45)	14 (14)
II	147 (46)	91 (42)	56 (55)
III	60 (19)	29 (13)	31 (31)
Decompensated stage	238 (74)	151 (69)	87 (86)	0.001
Arterial blood gas
PH	7.44 (7.42-7.46)	7.43 (7.41-7.45)	7.45 (7.42-7.47)	< 0.001
P(A-a)O2, mmHg	16.7 (8.0-26.6)	14.4 (7.8-24.7)	23.6 (8.3-31.2)	0.014
PaO2, mmHg	94.5 (84.6-105.1)	95.8 (85.6-105.9)	92.0 (81.5-102.5)	0.062
PaCO2, mmHg	33.2 (29.9-36.9)	33.7 (30.7-37.3)	32.0 (28.7-35.4)	< 0.001
SpO2, %	97.6 (96.8-98.3)	97.6 (96.9-98.3)	97.5 (96.6-98.2)	0.25
Laboratory parameters
CRP, mg/L	7.27 (2.26-17.74)	5.70 (2.25-19.10)	8.73 (2.30-15.97)	0.92
PCT, ng/mL	0.11 (0.05-0.38)	0.10 (0.05-0.28)	0.11 (0.07-0.56)	0.063
WBC count, × 109/L	4.13 (2.91-6.15)	4.35 (3.16-6.42)	3.73 (2.58-5.02)	0.015
HGB, g/L	115 (95-131)	120 (99-135)	104 (84-117)	< 0.001
Platelet count, × 109/L	80 (55-125)	86 (63-133)	61 (41-93)	< 0.001
Neutrophil count, × 109/L	2.55 (1.67-4.34)	2.72 (1.82-4.57)	2.20 (1.42-3.81)	0.032
Lymphocyte count, × 109/L	0.84 (0.53-1.25)	0.90 (0.57-1.31)	0.68 (0.47-0.99)	0.002
NLR	2.97 (1.83-6.03)	2.72 (1.84-6.03)	3.31 (1.78-5.91)	0.41
PLR	93.7 (67.2-148.7)	95.9 (69.1-156.7)	88.0 (59.1-129.4)	0.074
LCR	0.11 (0.04-0.34)	0.11 (0.04-0.41)	0.11 (0.04-0.30)	0.62
SII	248 (132-509)	261 (145-534)	200 (93-454)	0.020
CAR	0.20 (0.07-0.58)	0.16 (0.07-0.56)	0.31 (0.08-0.61)	0.58
Albumin, g/L	33.1 (29.5-37.3)	34.7 (30.3-38.4)	31.0 (27.5-34.3)	< 0.001
Total protein, g/L	63.4 (57.8-69.0)	64.0 (58.6-69.4)	61.4 (57.4-67.5)	0.051
ALT, U/L	26 (18-47)	26 (18-51)	26 (19-35)	0.44
AST, U/L	43 (27-71)	41 (25-72)	47 (31-69)	0.11
TBIL, μmol/L	26.3 (16.6-50.2)	22.0 (14.9-38.5)	48.2 (26.8-87.4)	< 0.001
DBIL, μmol/L	11.6 (7.0-23.1)	9.1 (5.9-17.9)	20.6 (11.7-47.1)	< 0.001
BUN, mg/dL	5.59 (4.60-7.29)	5.58 (4.47-7.41)	5.59 (4.76-7.05)	0.94
Serum creatinine, mg/dL	62 (50-76)	62 (53-76)	62 (46-76)	0.40
Glucose, mg/dL	5.30 (4.71-6.44)	5.43 (4.84-6.82)	5.05 (4.56-5.79)	0.002
INR	1.19 (1.07-1.35)	1.14 (1.05-1.27)	1.30 (1.19-1.50)	< 0.001
D-dimer, mg/L	1.3 (0.4-4.2)	1.1 (0.4-4.2)	1.8 (0.8-4.1)	0.016
Prothrombin time, seconds	10.9 (9.7-12.5)	10.4 (9.5-11.8)	12.0 (11.0-13.9)	< 0.001
Prothrombin time activity, %	66 (55-80)	71 (60-83)	58 (47-67)	< 0.001
Sodium, mmol/L	140 (137-142)	140 (137-142)	140 (136-142)	0.39
Ultrasound
Ejection fraction, %	69 (64-73)	69 (63-73)	69 (65-72)	0.671
Cardiac output, L/minute	5.4 (4.3-6.7)	5.0 (4.2-6.1)	6.1 (4.6-7.1)	0.011
E to e’ ratio	9.0 (8.0-11.5)	9.0 (8.0-11.0)	10.0 (8.0-12.5)	0.017
Cardiac index, L/minute/m²	3.05 (2.60-3.80)	2.90 (2.50-3.53)	3.40 (2.80-4.15)	0.003
Portal vein diameter, mm	13.0 (11.1-15.0)	13.0 (11.0-15.0)	13.0 (12.0-15.0)	0.443
Biomarkers
S1P, pg/mL	46 (26-77)	51 (31-85)	33 (18-58)	< 0.001
Angiopoietin-2, pg/mL	3681 (2217-6473)	3110 (1975-5351)	5539 (3286-8805)	< 0.001
VWF, ng/mL	14.3 (7.4-30.5)	13.7 (7.2-29.7)	15.4 (8.9-30.9)	0.312
sE-selectin, ng/mL	18.7 (14.5-24.4)	19.3 (14.8-23.8)	17.1 (14.3-25.1)	0.912
ICAM-1, ng/mL	165 (95-304)	161 (92-280)	201 (104-410)	0.022
PDGF-BB, pg/mL	62 (34-112)	71 (38-123)	45 (25-76)	< 0.001
TNF alpha, pg/mL	42 (37-47)	42 (38-47)	41 (36-47)	0.412
VCAM-1, ng/mL	15.5 (10.0-22.3)	15.3 (10.1-21.2)	16.9 (10.0-23.4)	0.323
VEGF-A, pg/mL	121 (86-204)	117 (82-193)	124 (96-244)	0.062

¹Cause: If a patient has multiple etiologies simultaneously, record them separately.

Normally distributed continuous variables are displayed as the mean ± standard deviation and were compared using the independent samples Student’s t test. Non-normally distributed continuous variables are displayed as the median with interquartile range and were compared using the Mann-Whitney U test. Categorical variables are expressed as counts with percentages and were compared using Pearson’s χ² or Fisher’s exact test. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; BUN: Blood urea nitrogen; CAR: C-reactive protein-to-albumin ratio; CRP: C-reactive protein; DBIL: Direct bilirubin; HGB: Hemoglobin; ICAM-1: Intercellular adhesion molecule-1; INR: International normalized ratio; IPVD: Intrapulmonary vascular dilatation; LCR: Lymphocyte-to C-reactive protein ratio; MELD: Model for End-Stage Liver Disease; NAFLD: Non-alcoholic fatty liver disease; NLR: Neutrophil-to-lymphocyte ratio; P(A-a)O₂: Alveolar-arterial oxygen gradient; PaO₂: Partial pressure of oxygen in arterial blood; PaCO₂: Partial pressure of carbon dioxide in arterial blood; PCT: Procalcitonin; PDGF-BB: Platelet-derived growth factor BB; PH: Potential of hydrogen; PLR: Platelet-to-lymphocyte ratio; S1P: Sphingosine 1 phosphate; SII: Systemic inflammation index calculated as (neutrophil count × platelet count)/lymphocyte count; SpO₂: Peripheral oxygen saturation; TBIL: Total bilirubin; TNF: Tumor necrosis factor; VCAM-1: Vascular cell adhesion molecule-1; VEGF-A: Vascular endothelial growth factor A; vWF: Von Willebrand factor; WBC: White blood cell.