Prognostic value of serum fibronectin concentration in alcoholic cirrhotic patients

The aim of this study was to assess prospectively the prognostic value of serum fibronectin in 114 alcoholic cirrhotic patients and to compare serum fibronectin with other prognostic variables. The Cox model and log-rank test were used to compare survival rates at 1 year. Considered alone, serum fibronectin, age, serum albumin, total serum bilirubin, gamma-glutamyl transpeptidase, prothrombin time, presence of encephalopathy and ascites were associated with survival to 1 year. The estimated survival rate at the end of 1 year was, for patients with serum fibronectin greater than 165 mg per liter: 84 +/- 5%, and for patients with serum fibronectin less than or equal to 165 mg per liter: 53 +/- 7% (p less than 0.001). With the step-wise multidimensional analysis using the Cox model to assess the combined effect of several prognostic variables, serum fibronectin was the first variable selected followed by age, encephalopathy and serum albumin which entered the model by virtue of their independent prognostic value. Multivariate regression and partial correlation analysis showed that fibronectin was independently correlated with serum albumin, gamma-glutamyl transpeptidase and total serum bilirubin explaining that the prognostic value of albumin diminished and that the prognostic value of total serum bilirubin and gamma-glutamyl transpeptidase disappeared when combined with serum fibronectin.