Predictive value of LAR plus MHR for prognosis of patients with acute upper gastrointestinal bleeding
10.12007/j.issn.0258-4646.2024.07.011
- VernacularTitle:LAR联合MHR对急性上消化道出血患者预后的预测价值
- Author:
Pingfei YOU
1
;
Hongxu JIN
Author Information
1. 中国医科大学北方医院,北部战区总医院急诊医学科,沈阳 110011
- Keywords:
acute upper-gastrointestinal bleeding;
lactate/albumin ratio;
monocyte/high-density lipoprotein cholesterol ratio;
prognosis
- From:
Journal of China Medical University
2024;53(7):640-645
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the predictive value of serum lactate/albumin ratio(LAR)and monocyte/high-density lipoprotein cho-lesterol ratio(MHR)for the prognosis of patients with acute upper gastrointestinal bleeding.Methods Clinical data were collected from 440 patients with acute upper gastrointestinal bleeding treated at the Emergency Department of General Hospital Northern Theater Com-mand from January 2019 to October 2021.According to whether the main clinical outcome event of acute upper gastrointestinal bleeding occurred(death for any reason,recurrence of gastrointestinal bleeding,requirement for emergency surgery,interventional surgery),patients were divided into the main clinical outcome event group(group A,n=91)and the no-main clinical outcome event group(group B,n=349).A logistic regression analysis analyzed the factors influencing the main clinical outcome events.Receiver operating character-istic(ROC)curves,integrated discrimination improvement(IDI),net reclassification index(NRI),and calibration curves were used to ana-lyze the predictive efficacy of an early dynamic elevated LAR alone,MHR alone,and a combination thereof.Results The logistic regres-sion analysis showed that elevated LAR and MHR,increased age,and reduced hemoglobin and hematocrit levels were independent risk factors for the occurrence of the main clinical outcomes(all P<0.05).A correlation analysis showed that hemoglobin level was negatively correlated with MHR and LAR(r=-0.165 and-0.247,all P<0.01).Alanine aminotransferase(ALT)and prothrombin time(PT)were positively correlated with LAR(r=0.165 and 0.178,all P<0.01).PT was positively correlated with MHR(r=0.142,P<0.01).The ROC curve analysis results showed that the area under the curve of LAR alone,MHR alone,and the combination thereof was 0.665(95%CI:0.598-0.731),0.863(95%CI:0.821-0.905),and 0.886(95%CI:0.845-0.927),while the cut-off values of LAR and MHR were 0.332 and 0.715,respectively.The IDI,NRI,and calibration curve results showed that the predictive value of LAR plus MHR for the occurrence of the main clinical outcome event was better than that of either alone.The sensitivity and specificity of LAR plus MHR were 84.6%and 88.5%,respectively.Conclusion Early dynamic elevation of LAR and MHR has high predictive value for the main clinical outcome events in patients with acute upper gastrointestinal bleeding,and the predictive value of LAR plus MHR is better than that of either alone.
