Prognostic value of von-Willebrand factor in patients with liver cirrhosis and its relation to other prognostic indicators

Table 1 Classification scores, von-Willebrand factor concentration, and biochemical and hemostatic parameters¹

Parameter	n	mean ± SD	Min	Max	Percentiles
					25th	50th	75th
CTP score	71	8.94 ± 2.95	5.00	15.00	6.00	9.00	11.00
MELD score	71	19.72 ± 9.86	6.00	59.00	11.00	18.00	25.00
vWF (%)	71	346.18 ± 155.97	150	850	214.00	318.40	410.10
CRP (mg/L)	71	21.15 ± 27.50	0.60	116.50	3.30	9.70	27.40
Ferritin (ng/mL)	62	290.45 ± 354.33	7.20	1586.10	47.50	149.40	464.30
Vitamin D (ng/mL)	46	17.65 ± 13.31	3.00	62.24	9.12	11.89	24.82
D-dimer (µg/mL)	69	2558.4 ± 1645.1	99.00	4500.00	969.90	2420.70	4427.00
PT (s)	71	20.50 ± 14.71	11.60	133.20	14.70	17.57	21.26
aPTT (s)	70	43.99 ± 14.32	23.56	120.00	35.53	41.94	48.07
TT (s)	70	24.10 ± 7.08	16.00	59.00	19.22	22.94	22.93
PLT (109/L)	71	105.51 ± 60.52	18.00	311.00	62.00	91.00	127.00
WBC (109/L)	71	6.62 ± 3.43	1.34	23.20	4.70	6.20	7.50
Bilirubin (µg/mL)	71	84.73 ± 119.64	8.00	611.00	25.30	39.30	83.00
Albumin (µg/mL)	71	29.68 ± 7.88	12.00	46.00	24.00	29.00	35.00
Sodium (µg/mL)	71	135.65 ± 4.77	117.00	141.00	134.00	137.00	138.00
Creatinine (µg/mL)	71	106.02 ± 96.15	41.00	530.00	61.30	72.00	105.40

¹The values are expressed as mean ± standard deviation (SD).

CTP: Child-Turcotte-Pugh; MELD: Model for end-stage liver disease; vWF: von-Willebrand factor; CRP: C-reactive protein; PT: Prothrombin time; aPTT: Activated partial thromboplastin time; TT: Thrombin time; PLT: Platelets; WBC: White blood cell.

Table 2 The relation between von-Willebrand factor and stage of disease, systemic inflammatory response syndrome, and other inflammatory and prognostic indicators¹

Parameter	vWF							P value
	n	mean ± SD	Min	Max	Percentiles
					25th	50th	75th
CTP score
Class A	18	258.0 ± 104.2	150	586	190.0	228.0	276.0	Kruskal-Wallis H test: Chi-square (2) = 10.8177; P = 0.0045a
Class B	25	336.5 ± 122.5	150	650	262.0	341.0	400.0
Class C	28	411.5 ± 182.2	198	850	246.0	402.8	560.0
Class А/B = Mann-Whitney U test: Z = -2.191; P = 0.028a
Class А/C = Mann-Whitney U test: Z = -3.028; P = 0.002a
Class B/C = Mann-Whitney U test: Z = -1.639; P = 0.101
MELD score
Group 1	9	271.5 ± 106.3	150	513	225.0	257.0	276.0	Kruskal-Wallis H test: Chi-square (2) = 10.3357; P = 0.0057a
Group 2	33	301.0 ± 115.9	161	650	200.0	296.0	350.0
Group 3	29	420.8 ± 179.7	150	850	258.0	409.0	548.0
Group 1/2 = Mann-Whitney U test: Z = -0.690; P = 0.507
Group 1/3 = Mann-Whitney U test: Z = -0.031; P = 0.029a
Group 2/3 = Mann-Whitney U test: Z = -2.942; P = 0.003a
SIRS score
SIRS (+)	43	339.2 ± 142.0	150	680	200.0	336.5	409.0	Mann-Whitney U test: Z = -0.3529; P = 0.7241
SIRS (-)	28	356.9 ± 177.5	150	850	216.0	309.2	410.8
Ferritin (ng/mL)
< 200	39	310.0 ± 140.7	150.0	650.0	198.0	262.0	405.0	Kruskal-Wallis H test: Chi-square (2) = 7.1653; P = 0.0278a
200-400	5	343.3 ± 91.2	253.0	458.9	258.0	336.5	410.1
> 400	18	423.9 ± 171.0	199.7	850.0	300.0	400.5	548.0
< 200/200-400 = Mann-Whitney U test: Z = -0.292; P = 0.311
< 200/> 400 = Mann-Whitney U test: Z = -2.584; P = 0.010a
200-400/> 400 = Mann-Whitney U test: Z = -0.820; P = 0.446
Vitamin D (ng/mL)
≤ 20	22	279.8 ± 108.9	150.0	513.0	199.7	241.0	344.0	Mann-Whitney U test: Z = -1.6916; P = 0.0907
> 20	23	372.0 ± 179.8	161.0	850.0	214.0	385.0	458.9
PLT (109/ L)
≤ 100	40	350.8 ± 171.4	161	850	207.2	312.7	412.1	Mann-Whitney U test: Z = -0.02898; P = 0.9769
> 100	31	340.2 ± 136.0	150	598	239.0	337.0	405.0
D-dimer (µg/mL)
≤ 500	6	205.2 ± 38.5	150	262	187.2	203.5	225.0	Mann-Whitney U test: Z = 2.6407; P = 0.0083a
> 500	63	355.9 ± 156.2	150	850	216.0	337.0	411.5

¹The values are expressed as mean ± standard deviation (SD).

^aP< 0.05.

von-Willebrand factor (vWF) was significantly higher in higher Child-Turcotte-Pugh (CTP) class, model for end-stage liver disease (MELD) group, serum ferritin (SF) group and in patients with elevated D-dimer level. SIRS: Systemic inflammatory response syndrome; PLT: Platelets.

Table 3 Univariate Cox proportional model and univariate logistic regression analysis¹

Parameter	Univariate Cox proportional model						Univariate logistic regression analysis
	3-mo		6-mo		1-yr		3-mo		6-mo		1-yr
	Sig.	Exp (B)	Sig.	Exp (B)	Sig.	Exp (B)	Sig.	Exp (B)	Sig.	Exp (B)	Sig.	Exp (B)
vWF	0.004a	1.004	0.005a	1.006	0.000a	1.004	0.008a	1.005	0.005a	1.006	0.002a	1.007
MELD	0.000a	1.144	0.000a	1.157	0.000a	1.116	0.000a	1.191	0.000a	1.157	0.000a	1.176
CRP	0.000a	1.029	0.001a	1,044	0.000a	1.025	0.001a	1.044	0.001a	1.044	0.002a	1.046
Vitamin D	0.077	0.923	0.013a	0.877	0.040a	0.939	0.096	0.918	0.013a	0.877	0.061	0.931
Ferritin	0.119	1.001	0.333	1.001	0.016a	1.001	0.104	1.001	0.333	1.001	0.015a	1.003
aPTT	0.000a	1.05	0.068	1.052	0.000a	1.051	0.059	1.049	0.068	1.052	0.067	1.055
TT	0.258	1.034	0.588	1.02	0.426	1.021	0.292	1.041	0.588	1.02	0.529	1.023
D-dimer	0.061	1	0.014a	1	0.059	1	0.003a	1.001	0.014	1	0.008	1
	Dependent variable-survival in days; significant for aP < 0.05						Dependent variable-mortality no/yes; significant for aP < 0.05

¹von-Willebrand factor (vWF), model for end-stage liver disease (MELD) score, and C-reactive protein (CRP) were significantly associated with 3-mo, 6-mo, and 1-yr survival and significant predictors of 3-mo, 6-mo, and 1-yr mortality.

^aP< 0.05.

aPTT: activated partial thromboplastin time; TT: thrombin time.