(Factor VIII / Factor V) Ratio as a New Prognostic Marker for Decompensated Liver Cirrhosis

M. El Horri¹, N. Feghoul¹, F. El Horri², I. Khachaa¹, A. Chikh Khelifa³, M. Baghdadi¹, A. Benglia¹, K. Benbouhadi¹, H. Mimene¹, K. Kebir¹, K. Benhalima¹, L. Benmahdi¹, H. BROUK⁴

¹Regional Military University Hospital of Oran, Oran, Oran, Algeria, ²Mixed Hospital of Ras elma, Sidi Bel Abbes, Sidi Bel Abbes, Algeria, ³Regional Military University Hospital of Oran, Saida, Saida, Algeria, ⁴Faculty of medicine, University of Badji Mokhtar of Annaba, Annaba, Annaba, Algeria

Abstract Number: PB0726

Meeting: ISTH 2022 Congress

Theme: Hemostatic Systems in Cancer, Inflammation and Immunity » Coagulation Proteins Beyond Hemostasis

Background: Factor VIII is synthesized by the liver but also by endothelial cells. Thus, its concentration does not decrease with liver cirrhosis and may even be increased due to endothelial dysfunction. But this increase does not correlate with the worsening of the disease due to the deterioration of liver function. Therefore we hypothetically assumed that the expression of factor VIII according to factor V could fill this gap.

Aims: To assess the prognosis value of the RATIO (Factor VIII / Factor V) in predicting mortality in decompensated hepatic cirrhosis.

Methods: A prospective cohort was conducted on 60 decompensated cirrhotic patients. All these patients got a measurement of factor VIII and factor V and the ratio was calculated. The endpoint was the occurrence of death.

Results: Patients were followed for a median of 15 months, after which 38% of death cases were noticed and we recorded one tracking lost.

The ratio (FVIII/FV) was significantly higher in deceased patients compared to survivors: 5.79 [CI: 4.36–7.21] versus 3.49 [CI: 2.91–3.98]; p=0.001.

The threshold value of 4.76 for our ratio which made it possible to predict death with a sensitivity of 56.52% and a specificity of 89%. Patients with a ratio < 4.76 (group I): had a mean survival of 17.3 months and a survival probability of 75.5% at 12 months. Those whose ratio exceeded 4.76 (group II): had a mean survival of 4.6 months with a survival probability of 60.8% at 12 months. Patients in group II had higher risk of mortality than those in group I , with a HR = 4.5 [IC : 1,95 – 10,35].

Conclusion(s): The ratio (FVIII/FV) is a good prognosis marker allowing the prediction of mortality in decompensated cirrhotic patients, independently of the Child Pugh and MELD score.The results found are promising and should arouse the interest of researchers in this field.

Table

Tab 1. Association Between -Factor VIII / Factor V- Ratio and mortality in patients with decompensated liver cirrhosis

Table

Tab 2. Survival analysis in decompensated liver cirrhosis according to -F VIII / F V- Ratio

To cite this abstract in AMA style:

El Horri M, Feghoul N, El Horri F, Khachaa I, Chikh Khelifa A, Baghdadi M, Benglia A, Benbouhadi K, Mimene H, Kebir K, Benhalima K, Benmahdi L, BROUK H. (Factor VIII / Factor V) Ratio as a New Prognostic Marker for Decompensated Liver Cirrhosis [abstract]. https://abstracts.isth.org/abstract/factor-viii-factor-v-ratio-as-a-new-prognostic-marker-for-decompensated-liver-cirrhosis/. Accessed November 30, 2023.

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