Occurrence of cirrhosis-related complications is a time-dependent prognostic predictor independent of baseline model for end-stage liver disease score
Occurrence of cirrhosis-related complications is a time-dependent prognostic predictor independent of baseline model for end-stage liver disease score
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DOI：
10.1111/j.1478-3231.2005.01190.x
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发表时间：
2006-02-01
影响因子：
6.7
通讯作者：
Lee, SD
中科院分区：
文献类型：
--
作者：
Huo, TI;Lin, HC;Lee, SD
背景：终末期肝病模型(MELD)用于确定等待肝移植的肝硬变患者的优先顺序。许多与肝硬变相关的并发症是移植的适应症，但不包括在MELD中。本研究调查了这些并发症对存活率的影响以及与MELD的关系。方法：分析包括食道静脉曲张出血在内的肝硬变相关并发症的死亡风险。对227例肝硬变患者的自发性细菌性腹膜炎、肝性脑病、肝肾综合征和肝失代偿进行了时间相关的COX回归模型分析。结果：142例(63%)患者发生并发症281例。死亡患者的基线MELD评分显著高于存活患者(14.5+/-4.5vs12.8+/-3.9，P=0.004)。有并发症组与无并发症组的MELD评分差异无统计学意义(13.6+/-4.3vs12.9+/-4.0，P=0.093)。基线MELD评分较高的患者易发生早期并发症(Rho=-0.598，P
Background: The model for end-stage liver disease (MELD) is used to prioritize cirrhotic patients awaiting liver transplantation. Many cirrhosis-related complications are indications for transplantation but are not included in MELD. This study investigated the impact of these complications on survival and association with MELD. Methods: The mortality risk of cirrhosis-related complications, including bleeding esophageal varices. spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome and hepatic decompensation, was analyzed using a time-dependent Cox regression model in 227 cirrhotic patients. Results: A total of 281 episodes of complications occurred in 142 (63%) patients. Patients who died had a significantly higher baseline MELD score compared with those who survived (14.5 +/- 4.5 vs 12.8 +/- 3.9, P=0.004). There was no significant difference in the MELD score between patients with and without the occurrence of complications (13.6 +/- 4.3 vs 12.9 +/- 4.0, P=0.093). Patients with a higher baseline MELD score tended to develop early complications (rho=-0.598, P