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

BACKGROUND Von-Willebrand factor(v WF) disposes certain prognostic value in patients with liver cirrhosis, but its relation to other prognostic indicators has not been fully investigated.AIM To analyze the relation between v WF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality.METHODS This analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension. It analyzed the relation between v WF and the stage of the disease and several inflammatory and prognostic indicators. The prospective analysis, performed on a sample of 63 patients, evaluated the association between the selected variables [v WF, Model for End-stage Liver Disease(MELD) score, C-reactive protein(CRP), ferritin, vitamin D, activated partial thromboplastin time, thrombin time, D-dimer concentration] and the survival time as well as their predictive value in terms of 3-mo, 6-mo and 1-year mortality.RESULTS v WF was significantly higher in patients with higher Child-Turcotte-Pugh class(P = 0.0045), MELD group(P = 0.0057), ferritin group(P = 0.0278), and D-dimer concentration(P = 0.0232). v WF significantly correlated with D-dimer concentration, ferritin, CRP, International Normalized Ratio, and MELD, Child-Turcotte-Pugh, Sequential Organ Failure Assessment, and CLIF-consortium organ failure(CLIF-C OF) scores. v WF, MELD score, and CRP were significantly associated with death and were significant predictors of 3-mo, 6-mo, and 1-year mortality. Each v WF unit significantly increased the probability for 3-mo mortality by 1.005 times(P = 0.008), for 6-mo mortality by 1.006 times(P = 0.005), and for 1-year mortality by 1.007 times(P = 0.002). There was no significant difference between the diagnostic performance of v WF and MELD score and also between v WF and CRP regarding the 3-mo, 6-mo, and 1-year mortality.CONCLUSION In patients with liver cirrhosis, v WF is significantly related to other prognostic indicators and is a significant predictor of 3-mo, 6-mo, and 1-year mortality similar to MELD score and CRP.