A study on relationship between severity of liver cirrhosis and pulmonary function tests

Abstract

Introduction: “Liver cirrhosis represents the final common pathway for chronic liver diseases, characterized by fibrosis, architectural distortion, and hepatic dysfunction.” While hepatic manifestations are well-documented, cirrhosis affects multiple organ systems, including the lungs. Pulmonary complications in cirrhosis include hepatopulmonary syndrome, portopulmonary hypertension, hepatic hydrothorax, and altered pulmonary function, significantly impacting morbidity and mortality. “This study aimed to evaluate the relationship between liver cirrhosis severity and pulmonary function parameters to establish patterns that might guide clinical management and prognostication.” Methods: “Sixty-five patients with liver cirrhosis were categorized according to Child- Pugh classification: Child A (n=6), Child B (n=21), and Child C (n=38).” Demographic characteristics, clinical features, Child-Pugh and MELD scores, ultrasonographic findings, arterial blood gases, and pulmonary function tests were assessed. Pulmonary function parameters included FVC, FEV1, FEV1/FVC ratio, and FEF 25-75%, measured both pre- and post-bronchodilator administration. Statistical analysis included ANOVA, chi-square test, and correlation analysis. Results: Significant differences were observed in age across Child-Pugh groups (p=0.019). Child-Pugh and MELD scores showed expected significant differences (p<0.001). Ascites severity increased significantly with worsening liver function (p<0.001). Pulmonary function tests revealed significant declines in FVC and FEV1 percentages with increasing disease severity (p<0.05), both pre- and post-Docusign Envelope ID: 62549D81-9846-4EA0-8665-A57F5665692E bronchodilator. Restrictive ventilatory pattern predominated in Child C patients (94.7%) compared to Child A (33.3%) and Child B (47.6%) (p<0.001). Arterial blood gases showed a trend toward decreasing pH and PO2 with worsening liver function. Significant negative correlations were found between Child-Pugh score and pulmonary function parameters, including FVC, FEV1, and FEF 25-75% (p<0.001), while correlations with MELD score were weaker but still significant for FVC and FEV1. Conclusion: Pulmonary function deteriorates progressively with increasing severity of liver cirrhosis, predominantly manifesting as a restrictive pattern in advanced disease. The significant negative correlations between liver disease severity scores and pulmonary function parameters suggest that pulmonary impairment parallels hepatic dysfunction. These findings highlight the importance of routine pulmonary function assessment in cirrhotic patients, particularly those with advanced disease, to identify abnormalities early and implement appropriate interventions