Impact of spider nevus and subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis.

Introduction: Spider nevus and subcutaneous collateral vessel of the chest/abdominal wall are common in liver cirrhosis. This prospective study aimed to evaluate the impact of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall on the outcomes of cirrhotic patients.

Material and methods: We prospectively enrolled patients with a diagnosis of liver cirrhosis consecutively admitted to our department. We recorded the number and location of spider nevi and subcutaneous collateral vessels of the chest/abdominal wall. Clinical profiles and survival were compared according to the presence of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall. The study was registered (NCT02468479).

Results: Overall, 198 patients were enrolled between June 2015 and May 2016. The median follow-up duration was 350 days. The prevalence of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall was 47% and 29.8%, respectively. Patients with spider nevi had a significantly higher proportion of alcohol abuse (54.84% vs. 26.67%, p < 0.001). Both spider nevus and subcutaneous collateral vessel of the chest/abdominal wall were significantly associated with higher Child-Pugh (8.35 ±2.19 vs. 7.47 ±1.91, p = 0.005; 8.57 ±2.20 vs. 7.60 ±1.98, p = 0.002) and MELD scores (9.91 ±6.41 vs. 7.43 ±5.40, p = 0.008; 10.77 ±6.76 vs. 7.68 ±5.42, p = 0.003). The cumulative survival was not significantly different between patients with and without spider nevi of the chest/abdominal wall ( p = 0.951). Patients with subcutaneous collateral vessels of the chest/abdominal wall had significantly worse cumulative survival ( p = 0.018).

Conclusions: Presence of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall indicated more severe liver dysfunction. Subcutaneous collateral vessel of the chest/abdominal wall should be a simple and important predictor for the overall survival of cirrhotic patients.