中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 6
Jun.  2020
Turn off MathJax
Article Contents

Value of the COSSH-ACLFs model in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2020.06.014
Research funding:

 

  • Published Date: 2020-06-20
  • Objective To investigate the value of the COSSH-ACLFs model in predicting the short-term( 90-day) prognosis of patient with hepatitis B virus-related acute-on-chronic liver failure( HBV-ACLF). Methods A total of 573 patients who were diagnosed with HBV-ACLF in The Affiliated Hospital of Southwest Medical University,The First People's Hospital of Neijiang,and The Second People's Hospital of Yibin were enrolled,and their general information and laboratory markers were collected. According to the outcome on day90 after diagnosis,the patients were divided into survival group with 339 patients and death group with 234 patients. The t-test was used for comparison of normally distributed continuous data between two groups,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups,and the Wilcoxon rank sum test was used for comparison of ranked data between two groups. The area under the receiver operating characteristic curve( AUC) was used to compare the value of different models in predicting 90-day prognosis. Results Compared with the survival group,the death group had significantly higher age( Z =-0. 304,P = 0. 002),bilirubin( Z =-5. 961,P < 0. 001),peripheral white blood cell count( Z =-6. 027,P < 0. 001),and creatinine( Z =-4. 638,P < 0. 001),significantly lower hemoglobin( Z =-2. 012,P = 0. 044),albumin( Z =-4. 007,P < 0. 001),and Na( Z =-4. 558,P < 0. 001),and significantly higher incidence rates of hepatic encephalopathy( Z =-7. 859,P < 0. 001),peritonitis( Z =-2. 310,P = 0. 021),and upper gastrointestinal bleeding( χ2= 11. 697,P =0. 001). Compared with the death group,the survival group had significantly better coagulation markers,prothrombin time,international normalized ratio,and prothrombin time activity( Z =-7. 737,-7. 672,and-7. 867,all P < 0. 001). MELD,MELD-Na,CLIF-COFs,CLIF-CACLFs,and COSSH-ACLFs had an area under the ROC curve( AUC) of 0. 726,0. 587,0. 712,0. 735,and 0. 750,respectively,and the COSSH-ACLFs model had a significantly larger AUC than the other four models( Z = 7. 89,18. 83,12. 49,and 5. 05,all P < 0. 001). Conclusion The COSSH-ACLFs model has a better value than CLIF-C ACLFs,MELD,CLIF-C OFs,and MELD-Na in predicting the short-term prognosis of patients with HBV-ACLF.

     

  • loading
  • [1] KATOONIZADEH A,LALEMAN W,VERSLYPE C,et al. Early features of acute-on-chronic alcoholic liver failure:A prospective cohort study[J]. Gut,2010,59(11):1561-1569.
    [2] SARIN SK,KEDARISETTY CK,ABBAS Z,et al. Acute-onchronic liver failure:Consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL)2014[J]. Hepatol Int,2014,8(4):453-471.
    [3] MALINCHOC M,KAMATH PS,GORDON FD,et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts[J]. Hepatology,2000,31(4):864-871.
    [4] ZHENG YX,ZHONG X,LI YJ,et al. Performance of scoring systems to predict mortality of patients with acute-on-chronic liver failure:A systematic review and meta-analysis[J]. J Gastroenterol Hepatol,2017,32(10):1668-1678.
    [5] BIGGINS SW,KIM WR,TERRAULT NA,et al. Evidencebased incorporation of serum sodium concentration into MELD[J]. Gastroenterology,2006,130(6):1652-1660.
    [6] XUN YH,SHI JP,LI CQ,et al. Prognostic performance of a series of model for end-stage liver disease and respectiveΔscores in patients with hepatitis B acute-on-chronic liver failure[J]. Mol Med Rep,2014,9(5):1559-1568.
    [7] JALAN R,SALIBA F,PAVESI M,et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure[J]. J Hepatol,2014,61(5):1038-1047.
    [8] HERNAEZ R,SOLE,MOREAU R,et al. Acute-on-chronic liver failure:An update[J]. Gut,2017,66(3):541-553.
    [9] ENGELMANN C,THOMSEN KL,ZAKERI N,et al. Validation of CLIF-C ACLF score to define a threshold for futility of intensive care support for patients with acute-on-chronic liver failure[J]. Crit Care,2018,22(1):254.
    [10] WU T,LI J,SHAO L,et al. Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-onchronic liver failure[J]. Gut,2018,67(12):2181-2191.
    [11] Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association; Severe Liver Disease and Artificial Liver Group,Chinese Society of Hepatology,Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol,2019,35(1):38-44.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2018年版)[J].临床肝胆病杂志,2019,35(1):38-44.
    [12] ZHANG DJ,ZHOU B,HOU JL. Research progress in prognostic models of acute-on-chronic liver failure[J]. J Clin Hepatol,2018,34(6):1351-1356.(in Chinese)张东敬,周彬,侯金林.慢加急性肝衰竭预后模型的研究进展[J].临床肝胆病杂志,2018,34(6):1351-1356.
    [13] SONG Y,SHEN Y,LU W,et al. Analysis of biochemical features of hepatitis B virus Infected patients in southwest China[J]. Clin Lab,2016,62(9):1803-1807.
    [14] CHENG XP,ZHAO J,CHEN Y,et al. Comparison of the ability of the PDD-ICG clearance test,CTP,MELD,and MELDNa to predict short-term and medium-term mortality in patients with decompensated hepatitis B cirrhosis[J]. Eur J Gastroenterol Hepatol,2016,28(4):444-448.
    [15] LI N,HUANG C,YU KK,et al. Validation of prognostic scores to predict short-term mortality in patients with HBV-related acute-on-chronic liver failure:The CLIF-C OF is superior to MELD,CLIF SOFA,and CLIF-C ACLF[J]. Medicine(Baltimore),2017,96(17):e6802.
    [16] DING R,ZHAO H,YAN J,et al. Defination and treatment progress of acute-on-chronic liver failure[J/CD]. Chin J Liver Dis(Electronic Version),2018,10(1):1-5.(in Chinese)丁蕊,赵红,闫杰,等.慢加急性肝衰竭的定义及治疗进展[J/CD].中国肝脏病杂志(电子版),2018,10(1):1-5.
    [17] LANG E,GATIDIS S,FREISE NF,et al. Conjugated bilirubin triggers anemia by inducing erythrocyte death[J]. Hepatology,2015,61(1):275-284.
    [18] XIA Q,DAI X,ZHANG Y,et al. A modified MELD model for Chinese pre-ACLF and ACLF patients and it reveals poor prognosis in pre-ACLF patients[J]. PLo S One,2013,8(6):e64379.
    [19] WU JZ,YANG XX,JIANG N. Relationship analysis on serum albumin level and MELD score in hepatitis B patients with acute liver failure[J]. J Aerospace Med,2017,28(7):811-812.(in Chinese)吴家箴,杨兴祥,江南.乙肝慢加急性肝衰竭患者血清Alb水平和MELD评分关系分析[J].航空航天医学杂志,2017,28(7):811-812.
    [20] ZHANG XF. Retrospective analysis of the prognosis of chronic plus acute liver failure[D]. Fuzhou:Fujian Medical University,2016.(in Chinese)张雪菲.慢加急性肝衰竭预后回顾性分析[D].福州:福建医科大学,2016.
    [21] LI Y. Clinical study on the prognostic factors of liver failure[D]. Changchun:Jilin University,2013.(in Chinese)李蓥.影响肝衰竭预后因素的临床研究[D].长春:吉林大学,2013.
    [22] KIM HY,CHANG Y,PARK JY,et al. Characterization of acute-on-chronic liver failure and prediction of mortality in Asian patients with active alcoholism[J]. J Gastroenterol Hepatol,2016,31(2):427-433.
    [23] TIAN XL,PENG Y,WU SL,et al. Liver failure staging and MELD predicted the short term prognosis of HBV-acute-on-chronic liver failure[J]. Chongqing Med,2017,46(8):1079-1081.(in Chinese)田小利,彭颖,吴松林,等.肝衰竭分期联合MELD评分对肝衰竭短期预后判断的研究[J].重庆医学,2017,46(8):1079-1081.
    [24] LIU XH,LI M,GUO HQ,et al. Dynamic changes of MELD scores can predict the prognosis of HBV-related acute-on-chronic liver failure[J]. Infect Dis Info,2014,27(2):78-81.(in Chinese)刘晓慧,李铭,郭海清,等.动态MELD评分有助于预测HBV相关慢加急性肝衰竭预后[J].传染病信息,2014,27(2):78-81.
    [25] CAI XJ,SHEN Y,ZHU XH,et al. Evaluation of integrated model for end-stage liver disease model in predicting prognosis of acute-onchronic liver failure and the choice of treatment[J/CD]. Chin J Exp Clin Infect Dis(Electronic Edition),2018,12(5):446-452.(in Chinese)蔡晓娟,沈毅,朱晓红,等.整合终末期肝病模型在慢加急性肝功能衰竭预后判断及治疗中的应用[J/CD].中华实验和临床感染病杂志(电子版),2018,12(5):446-452.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1123) PDF downloads(158) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return