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360A AASLD ABSTRACTS HEPATOLOGY, October, 2015 pressure (mPAP)
HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 361A was observed between the two groups of patients as far as demographic, clinical, hemodynamic, and laboratory characteristics. No treatment was provided for Grade 1 ascites in the study. During the follow up twenty-two patients developed Grade 2 or 3 ascites, 14 in Group A (14,7 %) and 8 in Group B (25.0%, p = N.S.). In only 4 out of 14 patients of Group A, Grade 1 ascites was detected before they developed Grade 2 or 3 ascites. The mean time for the development of Grade 2 or 3 ascites was shorter in Group B than in Group A, but the difference was not statistically significant (17,00 ± 11,06 versus 32,29 ± 27,59 months, p = N.S.). In nineteen patients in Group B (59.3%), Grade 1 ascites disappeared during the follow up. At univariate analysis, the finding of Grade 1 ascites, MELD, spleen diameter and the ratio platelets/spleen diameter were found as potential predictors of Grade 2 or 3 (Table). At multivariate analysis only the ratio platelets/spleen diameter was found to be the only independent predictor of Grade 2 or 3 ascites (HR = 0,997, 95%, CI : 0,994; 0,999, p = 0,0018 per el/mm 3 /mm of increase). In conclusion, the presence of Grade 1 ascites is neither a precursor nor an independent predictor of Grade 2 or 3 ascites in patients with cirrhosis. Thus, Grade 1 ascites does not require any treatment, including sodium dietary restriction. Disclosures: Paolo Angeli - Advisory Committees or Review Panels: Sequana Medical The following authors have nothing to disclose: Marta Tonon, Salvatore Piano, Matjaz Grbec, Chiara Pilutti, Silvano Fasolato, Antonietta Romano, Sara Montagnese, Filippo Morando, Massimo Bolognesi, Marialuisa Stanco, Giancarlo Bombonato, Silvia Rosi, Elisabetta Gola, Antonietta Sticca 293 Validation of Ascites-specific Patient Reported Outcome Questionnaires for Patients with Cirrhosis Patrick S. Kamath 3 , Myrte Neijenhuis 3 , Tom J. Gevers 2 , Thomas Atwell 1 , Joost Drenth 2 , Tim Gunneson 3 ; 1 Division of Gastroenterology, Hepatology & Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN; 2 Gastroenterlogy and Hepatology, Radboud University Nijmegen Medical Centre, Nijmeten, Netherlands; 3 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN Background and aim: Since no treatment improves long-term survival, treatment of ascites should focus on symptom relief and prevention of complications. No patient reported outcomes have been used as endpoints in clinical trials in cirrhotic ascites. We aimed to identify a sensitive tool to measure symptoms in cirrhotic ascites. Methods: We identified 12 ascites-specific symptoms (fullness, lack of appetite, early satiety, nausea, abdominal pain, back pain, dyspnea, limited mobility, fatigue, insomnia, dissatisfaction with size of abdomen and sexual intimacy problems) based on literature, patient interviews (n=8) and clinician survey (n=8) to develop an ascites-specific questionnaire (Ascites-Q). We administered Ascites-Q; Japanese Ascites Symptom Inventory-7 (ASI-7, developed for cirrhotic ascites); FACIT-ascites index (developed for malignant ascites); and quality of life (QoL) VAS-scale in cirrhotic patients undergoing large volume paracentesis (target sample size n=90). Scores were transformed to a 0-100 scale with higher scores indicating more symptoms. To identify ascites-specific symptoms, we compared using the Mann Whitney U test scores of patients with refractory ascites prior to paracentesis with scores in cirrhotic patients with no ascites recruited at the Mayo Clinic between January - May 2015. Correlations of QoL VASscale and ascites questionnaires were calculated (Spearman). Responsiveness of questionnaires to detect changes in symptoms was assessed by comparing scores at baseline and 7 days post paracentesis (paired T-test). Results: We included 32 patients with refractory ascites requiring large-volume paracentesis (59% male, mean age 61 yr, MELD-score 15 and median paracentesis volume 3600 mL; and 61 patients without refractory ascites (controls) (76% male, mean age 57 yr, MELD-score 11). Patients with refractory ascites scored higher than controls on all symptoms of Ascites-Q and ASI-7, except for Ascites-Q symptoms back pain (p=0.096) and fatigue (p=0.228). There was no difference between patients and controls in 6/13 FAC- IT-ascites index symptoms (insomnia, limited mobility, nausea, vomiting, polyuria and emotional distress). QoL correlated with Ascites-Q and ASI-7 (r=.497, p=0.008 and 0.471, p=0.013), but not with FACIT-ascites index (r=0.332, p=0.090). Scores of Ascites-Q, (-11.53 ± 18.874, p=0.013), ASI-7 (-35.46, ± 29.22, p
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1312A AUTHOR INDEX HEPATOLOGY, Octo
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1366A CATEGORY INDEX HEPATOLOGY, Oc
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