Wang Ran, Qi Xingshun, Guo Xiaozhong
Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110840, P.R. China.
Postgraduate College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110840, P.R. China.
Exp Ther Med. 2017 Dec;14(6):5733-5742. doi: 10.3892/etm.2017.5321. Epub 2017 Oct 17.
Ascites is among the most common complications of liver cirrhosis and is associated with a high mortality rate. The present retrospective study aimed to evaluate the potential correlation between in-hospital mortality of liver cirrhosis and volume of ascites. Patients with liver cirrhosis who were admitted to the General Hospital of Shenyang Military Region (Shenyang, China) between June 2012 and June 2014 and underwent axial abdomino-pelvic computed tomography (CT) scans were retrospectively reviewed. The volume of ascites was approximated using a five-point method, and diagnostic accuracy was expressed by the area under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs). Of the 177 patients reviewed in the present study, 117 (61.10%) exhibited ascites on CT scans, and the in-hospital mortality rate was 4.52% (8/177). Child-Pugh and model for end-stage liver disease (MELD) scores were significantly increased in the presence of ascites (P<0.001). The in-hospital mortality rate did not differ significantly between patients with and without ascites (P=0.052). In patients with ascites >300 ml (n=72), the AUROCs of the Child-Pugh score, MELD score, and ascites volume for predicting in-hospital mortality were 0.939 (95% CI, 0.856-0982), 0.952 (95% CI, 0.873-0.988), and 0.782 (95% CI, 0.668-0.871), respectively. These AUROCs did not differ significantly. In conclusion, quantification of ascites may aid to predict the in-hospital mortality rate of cirrhotic patients.
腹水是肝硬化最常见的并发症之一，且与高死亡率相关。本回顾性研究旨在评估肝硬化患者住院死亡率与腹水量之间的潜在相关性。对2012年6月至2014年6月间入住沈阳军区总医院（中国沈阳）并接受腹部盆腔轴向计算机断层扫描（CT）的肝硬化患者进行回顾性分析。采用五点法估算腹水量，并通过受试者操作特征曲线下面积（AUROC）及95%置信区间（CI）表示诊断准确性。本研究共纳入177例患者，其中117例（61.10%）CT扫描显示有腹水，住院死亡率为4.52%（8/177）。存在腹水时，Child-Pugh评分和终末期肝病模型（MELD）评分显著升高（P<0.001）。有腹水和无腹水患者的住院死亡率差异无统计学意义（P=0.052）。在腹水>300 ml的患者（n=72）中，Child-Pugh评分、MELD评分及腹水量预测住院死亡率的AUROC分别为0.939（95%CI，0.856-0.982）、0.952（95%CI，0.873-0.988）和0.782（95%CI，0.668-0.871）。这些AUROC差异无统计学意义。总之，腹水定量可能有助于预测肝硬化患者的住院死亡率。
