Salivary caffeine clearance predicts survival in patients with liver cirrhosis

Objective:Quantification of liver function in patients with cirrhosis is difficult, Caffeine clearance (CCl) has been suggested as a more exact method than those commonly used, The aim of this work was to assess the usefulness of CCl in survival prediction for these patients, Methods: Thirty-four patients with cirrhosis of the liver of various causes were included; 19 were class A or B in Child-Pugh's classification and 15 were class C. CCl was determined from saliva samples, The mean length of follow-up was 33.8 months, A bivariant survival analysis was carried out following the Kaplan-Meier method, together with a multivariant analysis using the Cox proportional hazards model, Results: Twelve patients died during the follow-up period. CCl values < 0.24 ml/kg/min, age > 60 yr, and nonalcoholic cause of cirrhosis were factors predicting lower survival, CCl was the only independent predictive factor in the multivariant analysis, Conclusions: CCl enables us to predict survival in cirrhotic patients and, considering its harmlessness, simplicity, and cost, can be used as a routine procedure in the assessment of these patients.