Clinical significance of CTP combined with ABIC score in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure
10.3760/cma.j.issn.1007-3418.2019.02.009
- VernacularTitle: CTP联合ABIC评分预测乙型肝炎相关性慢加急性肝衰竭患者短期预后的临床意义
- Author:
Dan CAO
1
;
Dajiang LI
;
Ying WANG
;
Yonghui ZHANG
;
Liyu CHEN
;
Lichun WANG
Author Information
1. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
- Publication Type:Journal Article
- Keywords:
Hepatitis B;
Prognosis;
Scoring model;
Hepatitis B-related acute-on-chronic liver failure
- From:
Chinese Journal of Hepatology
2019;27(2):118-122
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors affecting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and establish a new scoring model to predict the short-term prognosis of patients.
Methods:This study enrolled 222 patients with HBV-ACLF. According to their clinical outcomes during hospitalization and 90 days after discharge, they were divided into survival and death group. Clinical data were collected to calculate the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), albumin-bilirubin (ALBI), and age-bilirubin-international normalized ratio-creatinine (ABIC) scores for prognosis. Multivariate logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients. Cox regression model was used to establish a new prediction model. Area under the receiver operating characteristic curve was used to calculate short-term prognostic value of the models. K-M survival curve was used to predict the prognosis of patients.
Results:CTP and ABIC scores were independent risk factors for 90-day mortality in HBV-ACLF patients, and the risk of death from liver failure had increased with increase of score. Cox regression model established a new predictive model CTP-ABIC = 0.551 × CTP + 0.297 × ABIC. Area under the receiver operating characteristic curve of all three scoring models (CTP, ABIC and CTP-ABIC) were 0.878, 0.829, 0.927, respectively. CTP-ABIC score was superior to the CTP and ABIC score (P value < 0.001). Patients with CTP-ABIC score ≥9.08 had higher mortality rate than patients with CTP-ABIC score < 9.08, and the difference was statistically significant (P < 0.001).
Conclusion:All three scoring systems can predict short-term prognosis in patients with HBV-ACLF, but the accuracy of CTP-ABIC is superior.
