Red blood cell distribution width is a independent prognostic indicator for mortality in patients with HBV related acute-on-chronic liver failure.
10.12122/j.issn.1673-4254.2018.11.13
- Author:
Jiao QIN
1
;
Li QIANG
1
;
Wen CHEN
1
;
Gang WU
1
Author Information
1. Department of Infectious Diseases, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
- Publication Type:Journal Article
- Keywords:
hepatitis B virus;
liver failure;
prediction model;
red blood cell distribution width
- MeSH:
Acute-On-Chronic Liver Failure;
blood;
mortality;
Cell Size;
End Stage Liver Disease;
blood;
mortality;
Erythrocyte Volume;
Erythrocytes;
cytology;
Hepatitis B;
blood;
complications;
mortality;
Humans;
Prognosis;
ROC Curve;
Retrospective Studies
- From:
Journal of Southern Medical University
2018;38(11):1354-1359
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To establish a model for predicting the short-term prognosis of patients with HBV-related acute-onchronic liver failure (HBV-ACLF) based on red blood cell distribution width (RDW) and the model for end-stage liver disease (MELD) scores.
METHODS:A total of 245 patients with HBV-ACLF were retrospectively analyzed for their clinical data and results of routine hematological tests, liver function, renal function, coagulation test, HBV-DNA, and other indicators at admission. Univariate analysis and binary logistic regression analysis were used to test the short-term risk factors for death of the patients, and the MELD-RDW model was established. The accuracy of each index and the established model was verified using the ROC curve.
RESULTS:The surviving patients with HBV-ACLF had significantly decreased RDW (14.97 ± 1.38) and MELD score (23.54±4.35) compared with those in the patients dead within 90 days (17.05±2.92 and 28.95±5.99, respectively). Multivariate analysis indicated that RDW was a significant independent prognostic factor for mortality in patients with HBVACLF (OR=1.840, 95%CI: 1.47902.289, < 0.005). The risk assessment model was [logisticMELD-RDW]=-9.375+0.582×RDW- 0.091×ALB-0.05×PTA+0.186×MELD. The area under the ROC curve of MELD score combined with RDW was 0.878, which was higher than RDW (0.724) and MELD score (0.780) alone.
CONCLUSIONS:RDW is an independent prognostic indicator for mortality in patients with HBV-ACLF. Compared with MELD score, the risk assessment model based on MELD and RDW has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.
