The dynamic of platelet count as a novel and valuable predictor for 90-day survival of hepatitis B virus-related acute-on-chronic liver failure patients - 20/04/21
, Zhouhua Hou b, Yuyuan Xu a, Huimin Gu b, Guangyu Liang a, Yukun Huang bBienvenue sur EM-consulte, la référence des professionnels de santé.
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Summary |
Background |
The prognosis of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is extremely poor due to multiple organ dysfunction.
Objectives |
To investigate the prognostic risk factors and create a 90-day prognostic predictive model for the patients with HBV-ACLF.
Methods |
Demographic information, clinical examination, and laboratory test results of the enrolled patients were collected to study the prognostic risk factors. Univariate and multivariate analysis and stepwise Logistic regression were performed to develop the predictive model. External validation was performed to verify the model.
Results |
A total of 333 HBV-ACLF patients and 86 HBV-non-ACLF patients were included in this study. Age, alpha-fetoprotein (AFP), total bilirubin (TBIL), platelet (PLT), and international normalized ratio (INR) were found to be independent risk factors for poor outcomes of HBV-ACLF patients. The formula identified for the linear predictor (LP) of the prognosis of HBV-ACLF patients is thus: LPACLF=−5.04–0.056×age–0.002×AFP–0.010×PLT+0.002×TBIL+0.877×INR. The area under curve (AUC) of the receiver operating characteristic curve (ROC) was 0.7835 (95% CI 0.7248–0.8423).
Conclusions |
A predictive model with good calibration and discrimination for 90-day survival of HBV-ACLF patients, including 5 variables, namely age, AFP, PLT, TBIL, and INR was established. Platelet count was a sensitive and dynamic variable for the prognosis of HBV-ACLF.
Le texte complet de cet article est disponible en PDF.Keywords : Platelet, Alpha-fetoprotein, Acute-on-chronic liver failure, Prognosis
Abbreviations : HBV-ACLF, APASL, WBC, N, HB, AFP, TBIL, DBIL, ALB, GLO, ALT, AST, PT, PTA, INR, liver transplantation, SD, IQR, AUC, ROC
Plan
Vol 45 - N° 2
Article 101482- mars 2021 Retour au numéro
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