Survival of patients with hepatopulmonary syndrome related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension

BACKGROUND The hepatosplenic schistosomiasis (HSS) with portal hypertension can cause vascular complications such as hepatopulmonary syndrome (HPS). HPS increases the risk of mortality in patients with cirrhosis; however, there is no data on the mortality of patients with HSS and HPS. AIM To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension. METHODS From August 2023 to January 2024, medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed. Survival curves were created using the Kaplan-Meier method, and comparisons were performed using the log-rank test. Cox regression models estimated the hazard ratios (HR). RESULTS Overall, data of 113 patients were analyzed; most (55.8%) had HSS and concomitant cirrhosis (HSS/cirrhosis). Meanwhile, HPS was present in 39 (34.5%) patients. Death occurred in 65 patients [57.5%; 95% confidence interval (CI): 48%-67%. The average time to death was lower in those with HPS when compared to those without HPS (3.37 years vs 5.65 years; P = 0.017). According to the cause of liver disease, patients with HSS/cirrhosis died earlier, and their risk of death was twice as high compared with patients with HSS without cirrhosis (HR: 2.17; 95%CI: 1.3-3.60; P = 0.003). Meanwhile, there were no differences when comparing the two groups with and without HPS (HR: 1.01; 95%CI: 0.59-1.73; P = 0.967). CONCLUSION Patients with HSS and concomitant cirrhosis had a lower survival rate, but there was no difference in survival regardless of the presence of HPS.