University Clinic of Gastrohepatology, University Hospital Center "Mother Theresa", Dibra Street No. 370, Tirana, Albania.
Gastroenterol Res Pract. 2012;2012:539059. doi: 10.1155/2012/539059. Epub 2012 Feb 22.
Objective. We aimed to assess the predictive value of the model of end-stage liver disease (MELD) in hospitalized cirrhotic patients with and without spontaneous bacterial peritonitis (SBP) and fatal outcome. Methods. A cross-sectional study included 256 consecutive patients (199 men and 57 women) diagnosed with cirrhosis and ascites who were hospitalized at the University Hospital Center in Tirana from January 2008 to December 2009. SBP was defined as a neutrophil count of ≥250 cells/mm(3) in ascitic fluid. MELD score was based on laboratory parameters determined by UNOS Internet site MELD calculator. Results. In multivariable-adjusted logistic regression models controlling for age, sex, diabetes, and etiology, there was evidence of a positive association of SBP with MELD score: the odds ratio (OR) for SBP for one unit increment of MELD score was 1.06 (95% Cl = 1.02-1.09). MELD score was significantly higher in fatal cases than nonfatal patients (mean age-adjusted score was 32.7 versus 18.4 overall; 34.8 versus 18.0 in SBP patients, and 32.0 versus 18.5 in non-SBP patients; all P < 0.001). Conclusions. In this Albanian sample of hospitalized cirrhotic patients, MELD score was confirmed as a significant predictor of both SBP and fatal outcome.
目的。我们旨在评估终末期肝病模型(MELD)在伴有和不伴有自发性细菌性腹膜炎(SBP)的住院肝硬化患者以及致命结局中的预测价值。
方法。一项横断面研究纳入了 2008 年 1 月至 2009 年 12 月在地拉那大学医院中心住院的 256 例连续诊断为肝硬化和腹水的患者(199 名男性和 57 名女性)。SBP 的定义为腹水中性粒细胞计数≥250 个/毫米 3 。MELD 评分基于 UNOS 网站 MELD 计算器确定的实验室参数。
结果。在多变量调整的逻辑回归模型中,控制年龄、性别、糖尿病和病因,有证据表明 SBP 与 MELD 评分呈正相关:MELD 评分每增加 1 个单位,SBP 的比值比(OR)为 1.06(95%置信区间 1.02-1.09)。致命病例的 MELD 评分明显高于非致命患者(平均年龄调整评分总体为 32.7 与 18.4;SBP 患者为 34.8 与 18.0,非 SBP 患者为 32.0 与 18.5;所有 P < 0.001)。
结论。在这个阿尔巴尼亚住院肝硬化患者样本中,MELD 评分被证实是 SBP 和致命结局的重要预测指标。