Predictive Value of Age-Bilirubin-International Normalized Ratio-Creatinine Score in Short-Term Survival of Acute-on-Chronic Hepatitis B Liver Failure
Predictive Value of Age-Bilirubin-International Normalized Ratio-Creatinine Score in Short-Term Survival of Acute-on-Chronic Hepatitis B Liver Failure
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DOI：
10.1159/000495904
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发表时间：
2018-01-01
影响因子：
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通讯作者：
Yang, Yang
中科院分区：
文献类型：
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作者：
Chen, Liang;Zheng, Jun;Yang, Yang
背景/目标：年龄-胆红素-国际标准化比值-肌酐（ABIC）评分是酒精性肝炎常用的预测模型，尚未在慢加急性B型肝炎肝衰竭（HBV-ACLF）中进行研究。我们的目的是探讨ABIC评分在HBV-ACLF患者中的预测价值。研究方法：这项回顾性研究涉及398例诊断为HBV-ACLF的患者，他们被分为305例患者的训练队列和93例患者的验证队列。单变量和多变量考克斯回归模型用于确定死亡率的危险因素。计算受试者工作特征曲线下面积（AUC），估计并比较不同预后评分的预测值。结果：训练队列中死亡组的ABIC评分显著高于存活组。多变量考克斯分析确定的死亡率独立危险因素包括血尿素氮、ABIC评分和慢性肝功能衰竭联合器官衰竭（CLIF-C OF）评分。对于预测1个月和3个月死亡率，ABIC评分的AUC高于终末期肝病模型（MELD）评分（分别为0.732 vs. 0.653，P < 0.05，0.695 vs. 0.619，P < 0.05），CLIF-C OF评分Child-Pugh评分（分别为0.675，P =0.189，0.656，P=0.300）。ABIC评分> 9.44的患者1个月和3个月生存率降低。结论：ABIC评分对HBV-ACLF患者近期生存的预测价值上级优于MELD评分。ABIC评分> 9.44预测HBV-ACLF患者短期死亡风险高。(C)2018作者（S）由S发布。Karger AG，巴塞尔
Background/Aims: The age-bilirubin-international normalized ratio-creatinine (ABIC) score, which is a predictive model commonly used for alcoholic hepatitis, has not yet been studied in acute-on-chronic hepatitis B liver failure (HBV-ACLF). We aimed to investigate the predictive value of the ABIC score in patients with HBV-ACLF. Methods: This retrospective study involved 398 patients diagnosed with HBV-ACLF, who were divided into a training cohort of 305 patients and a validation cohort of 93 patients. Univariate and multivariate Cox regression models were used to determine risk factors for mortality. Area under the receiver operating characteristic curve (AUC) was calculated to estimate and compare the predictive values of different prognostic scores. Results: The ABIC score was significantly higher in the death group of the training cohort than in its survival group. Independent risk factors for mortality identified by multivariate Cox analysis included blood urea nitrogen, ABIC score, and Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) score. For predicting 1- and 3-month mortality, AUC was higher for the ABIC score than for the Model for End-stage Liver Diseases (MELD) score (0.732 vs. 0.653, P < 0.05, 0.695 vs. 0.619, P < 0.05, respectively), CLIF-C OF score (0.693, P=0.353, 0.656, P=0.341, respectively), and Child-Pugh score (0.675, P=0.189, 0.656, P=0.300, Respectively). Patients with ABIC score > 9.44 had reduced 1- and 3-month survival rates. Conclusion: ABIC score is superior to MELD score in predicting short-term survival in HBV-ACLF patients. ABIC score > 9.44 predicts high short-term mortality risk in HBV-ACLF patients. (C) 2018 The Author(s) Published by S. Karger AG, Basel