The utility of the 13C-methacetin breath test in predicting the long-term survival of patients with decompensated cirrhosis

Aim: The C-13-methacetin breath test (C-13-MeBT) is a noninvasive tool that allows evaluation of the functional activity of the liver and the prediction of liver cirrhosis. Nevertheless, there is no information on its potential utility to predict long-termsurvival in patients with liver disease. Methods: Patients with cirrhosis were selected. All patients underwent a complete clinical assessment, standard biochemical tests, and C-13-MeBT at the beginning of the study. Death was recorded during the three years of follow-up. Survival curves were calculated by the Kaplan-Meier method, and Cox proportional risk models were used to identify predictive factors. The ability to classify the overall risk was assessed by the C statistic. Results: One hundred and twenty-three patients were included. Asignificant inverse correlation was found between delta over baseline at the 15 min point (DOB15) after ingestion of C-13-methacetin and the Child-Pugh score (r = - 0.411, p < 0.001). Inmultivariate analysis, DOB15 <= 4.5 parts per thousand was associated with mortality, [HR = 2.58 95% CI (1.17-5.69)]. In conclusion, our results confirm the utility of C-13-MeBT as a simple, noninvasive tool to quantitatively assess the liver's functional reserve and as a potential predictor of long-termsurvival in patients with decompensated cirrhosis.