Platelet-albumin-bilirubin score in assessing short-term prognosis of patients with Budd-Chiari syndrome presenting with upper gastrointestinal bleeding
10.3760/cma.j.cn113884-20211202-00393
- VernacularTitle:血小板-白蛋白-胆红素评分在布-加综合征并发上消化道出血短期预后评估中的应用价值
- Author:
Xiaowei DANG
1
;
Dongqi SHEN
;
Luhao LI
;
Zhaochen LIU
;
Suxin LI
;
Peiju WANG
;
Jing YANG
;
Yuehui ZHANG
Author Information
1. 郑州大学第一附属医院肝胆胰外科（河南省布-加综合征诊疗中心），郑州 450052
- Keywords:
Budd-Chiari syndrome;
Esophageal and gastric varices;
Platelet-albumin-bilirubin score;
Upper gastrointestinal bleeding
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(4):264-269
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the factors influencing short-term prognosis of patients with Budd-Chiari syndrome (B-CS) presenting with upper gastrointestinal bleeding and to assess the predictive value of platelet-albumin-bilirubin score (PALBI) on death within 30 d in these patients.Methods:A retrospective study was conducted on 74 patients with B-CS who presented with upper gastrointestinal bleeding and were treated at the First Affiliated Hospital of Zhengzhou University from January 2014 to February 2020. There were 51 males and 23 females, with age of (46.5±11.1) years old. These patients were divided into the survival group ( n=58) and the death group ( n=16) according to the disease outcomes up to 30 d of follow-up. Factors influencing short-term deaths of these patients were analyzed, and the predictive values of PALBI, ALBI, CTP and MELD scores on short-term prognosis of the patients were assessed. The receiver operating characteristic (ROC) curves were plotted, and the areas under the curve (AUC) were calculated and compared. Results:The differences between patients in the survival and death groups for white blood cell, platelet, PALBI score, PALBI classification, ALBI score, CTP score, MELD score, and presence or absence of hepatic encephalopathy were significantly different (all P<0.05). Multivariate logistic regression analysis showed that CTP score≥10 or CTP grade C ( OR=1.669, 95% CI: 1.048-2.661), and PALBI score >-2.09 or PALBI grade 3 ( OR=5.245, 95% CI: 2.128-12.924) were independent risk factors for predicting death within 30 days. The areas under the ROC curves for PALBI, ALBI, CTP and MELD score were 0.89, 0.72, 0.77 and 0.76, with the cut-off values of -1.92, -1.60, 8.50 and 13.60, respectively. The differences between the PALBI score and ALBI, CTP scores were significantly different ( P<0.05). Conclusion:The PALBI score showed a positive predictive value on short-term prognostic assessment of patients with B-CS presenting with upper gastrointestinal bleeding. It was comparable to the effect of the MELD score but was significantly better than the ALBI and CTP scores.
