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Refractory Ascites Prognosis — SCE Palliative Medicine MCQ

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ModerateNon-Malignant Palliative CareRefractory Ascites PrognosisSCE Palliative Medicine

A 60-year-old woman with advanced liver cirrhosis (Child‑Pugh C) and refractory ascites has an indwelling tunnelled peritoneal drain for home drainage. She asks about the typical prognosis with refractory ascites. What should she be told?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Refractory ascites in Child‑Pugh C cirrhosis carries a median survival of about 6 months without transplantation — honest prognostic discussion enables appropriate planning

Explanation lettering: D = shown as A · A = shown as B · E = shown as D · B = shown as E

Option C is correct. UK palliative‑care guidelines (Right Decisions Scotland) state that patients with refractory ascites have a median survival around 6 months, and NICE acknowledges high 2‑year mortality (>50%) in such patients, with <20% surviving 5 years ([rightdecisions.scot.nhs.uk](https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/last-days-of-life-care-around-dying/end-stage-liver-disease/?utm_source=openai)). Honest prognosis enables shared decisions and planning. Option A denies any prognostic estimate, which is incorrect. Option B is overly optimistic. Options D and E wrongly imply no prognostic impact of refractory ascites.

Reference: NICE HTG648 (2022) and Right Decisions Scotland: End‑stage liver disease — mortality median ~6 months.