Prognostic Value of Total Serum Bilirubin/γ-Glutamyl Transpeptidase Ratio in Cirrhotic Patients

The aim of this study was to assess the prognostic value of total serum bilirubin (TSB), γ-glutamyl transpeptidase (GGT) and the TSB/GGT ratio in 129 consecutive cirrhotic patients, and to determine how seven other clinical and biochemical variables affect the prognostic value of these measurements. The Cox model and log rank test were used to compare survival rates at 1 year. Considered alone, encephalopathy, ascites, TSB, prothrombin time, serum albumin, GGT and the TSB/GGT ratio (TSB expressed in /imoles per liter and GGT in IU per liter were associated to the 1-year survival (p < 0.10). The estimated per cent surviving at the end of 1 year was 20% for those with encephalopathy and 59% for those without, 46% and 62% for those with and without ascites, 28% for those with TSB ± 3.0 mg per dl, 68% for those with TSB ± 3.0 mg per dl, 44% for those with GGT ± 100 IU per liter, 60% for those with GGT ± 100 IU per liter, and 12% for those with TSB/GGT ± 1, 66% for those with TSB/GGT ± 1. With the Cox model, which was used to assess the combined effect of several prognostic variables, GGT was the only biochemical variable which added significant prognostic value to TSB. The combination of TSB and GGT added significant prognostic value to encephalopathy and ascites.