Sequential analysis of variable markers for predicting outcomes in pediatric patients with acute liver failure.
Sequential analysis of variable markers for predicting outcomes in pediatric patients with acute liver failure.
复制标题
用于预测急性肝衰竭儿科患者预后的变量标记物的序列分析。
DOI：
10.1111/hepr.12859
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发表时间：
2016
期刊：
影响因子：
4.2
通讯作者：
Kasahara M
中科院分区：
文献类型：
--
作者：
Uchida H;Sakamoto S;Fukuda A;Sasaki K;Shigeta T;Nosaka S;Kubota M;Nakazawa A;Nakagawa S;Kasahara M
AimOur的目的是分析预测变量和评分系统的一系列变化，回顾性地适应于评估急性肝衰竭（ALF）的儿科患者的结局。根据肝移植（LT）的需要，将65例患者分为两组：LT组（n= 54）和非LT组（n= 11）。我们的研究使用了日本难治性肝胆疾病研究组（JIHBDSG）提出的LT适应症的早期确定评分系统。在诊断时（第0天）和诊断后第3天和第5天计算LT组和非LT组之间JIHBDSG评分的受试者工作特征曲线下面积（AUROC）。结果发现第5天JIHBDSG评分>3的患者识别需要LT的敏感性为83.7%，特异性为81.8%，诊断准确性为83.3%。基于AUROC值的比较，第5天的JIHBDSG评分（AUROC 0.91）高于第0天的评分（AUROC 0.75）和第3天的评分（AUROC 0.84）。然而，需要进一步的研究来验证我们的结果。
AimOur aim was to analyze serial changes in the predictive variables and a scoring system retrospectively adapted to evaluate outcomes in pediatric patients with acute liver failure (ALF).MethodsWe retrospectively collected data on 65 patients with ALF. The 65 patients were divided into two groups according to the need for liver transplantation (LT) as follows: LT group (n= 54) and non‐LT group (n= 11). The early determination scoring system of the indications for LT proposed by the Intractable Hepato‐Biliary Diseases Study Group of Japan (JIHBDSG) was used in our study. The area under the receiver operating characteristic curve (AUROC) was calculated for the JIHBDSG score between the LT group and non‐LT group at the time of diagnosis (day 0) and day 3, and day 5 after the diagnosis.ResultsA JIHBDSG score of >3 at day 5 was found to identify the patients requiring LT with 83.7% sensitivity, 81.8% specificity, and 83.3% diagnostic accuracy. Based on a comparison of AUROC values, the JIHBDSG score on day 5 (AUROC 0.91) was higher than that on day 0 (AUROC 0.75) and day 3 (AUROC 0.84).ConclusionWe showed that a serial analysis of the JIHBDSG score might be useful for predicting outcomes of ALF in pediatric patients who fulfilled the criteria of LT indication in our center. However, further studies are needed to validate our results.