Prohic Dzanela, Mesihovic Rusmir, Vanis Nenad, Puhalovic Amra
Department of Gastroenterohepatology, University Clinical Center Sarajevo, Bosnia and Herzegovina.
Med Arch. 2016 Feb;70(1):48-52. doi: 10.5455/medarh.2016.70.48-52. Epub 2016 Jan 31.
to determine ascites and serum sodium significance in short term mortality prediction in patients with advanced liver cirrhosis.
a cohort of 115 cirrhotic patients referred to our Department were followed up for 6 months in non-transplant settings. The c index equivalent to the area under the receiver operating curve (ROC) was calculated and compared to estimate the short-term prognostic accuracy of the following parameters: ascites, serum sodium and MELD score.
in patients with a MELD score less than 21, ascites and low serum sodium (c index 0,687, p<0 0,001 and 0,748, p<0,001 respectively) showed better prognostic accuracy and were independent predictors of mortality. For MELD scores above 21, only MELD was an independent mortality prognostic factor (c index 0,710, p<0,001).
in our study, sample ascites and low serum sodium help identify patients with advanced liver disease who are at high risk of mortality despite low MELD scores. These parameters should be considered as additional prognostic parameters that could improve available treatment options and outcomes in this group of patients.
确定腹水和血清钠在晚期肝硬化患者短期死亡率预测中的意义。
对转诊至我科的115例肝硬化患者在非移植情况下进行了6个月的随访。计算并比较了与受试者工作特征曲线（ROC）下面积等效的c指数，以评估以下参数的短期预后准确性：腹水、血清钠和终末期肝病模型（MELD）评分。
在MELD评分低于21的患者中，腹水和低血清钠（c指数分别为0.687，p<0.001和0.748，p<0.001）显示出更好的预后准确性，并且是死亡率的独立预测因素。对于MELD评分高于21的患者，只有MELD是独立的死亡率预后因素（c指数0.710，p<0.001）。
在我们的研究中，样本腹水和低血清钠有助于识别晚期肝病患者，这些患者尽管MELD评分较低，但仍有高死亡风险。这些参数应被视为额外的预后参数，可改善该组患者的现有治疗选择和结局。
